妊娠滋养细胞疾病中人绒毛膜促性腺激素及其游离亚基的差异产生

Differential production of human chorionic gonadotropin and free subunits in gestational trophoblastic disease.

作者信息

Ozturk M, Berkowitz R, Goldstein D, Bellet D, Wands J R

机构信息

Gastrointestinal Unit, Massachusetts General Hospital, Boston 02114.

出版信息

Am J Obstet Gynecol. 1988 Jan;158(1):193-8. doi: 10.1016/0002-9378(88)90809-5.

DOI:10.1016/0002-9378(88)90809-5

PMID:2447774

Abstract

Serum levels of human chorionic gonadotropin (hCG) and its free subunits (alpha hCG and beta hCG) were determined by means of highly sensitive and specific monoclonal and antipeptide-based monoclonal immunoradiometric assays. During normal pregnancy, the beta hCG to hCG ratio appears constant at approximately 0.5% after 5 weeks of gestation. In contrast, gestational choriocarcinoma was characterized by absolute serum beta hCG levels varying from three to 280 times greater than the maximum values observed during pregnancy and by exceedingly high beta hCG to hCG ratios. In complete hydatidiform mole, this ratio was intermediate between normal pregnancy and choriocarcinoma. The ratios of free beta hCG to hCG will distinguish normal from complete molar pregnancy (p less than 10(-8)), hydatidiform mole from choriocarcinoma (p less than 10(-4)), and choriocarcinoma from normal pregnancy (p less than 10(-8)) with high probability. Finally, it was found by means of the high sensitivity hCG immunoradiometric assays (less than 0.02 ng/ml) that this assay predicted very early tumor recurrence in patients with gestational choriocarcinoma.

摘要

采用高灵敏度和特异性的基于单克隆及抗肽的单克隆免疫放射分析方法测定血清中人绒毛膜促性腺激素（hCG）及其游离亚基（α-hCG和β-hCG）的水平。在正常妊娠期间，妊娠5周后β-hCG与hCG的比值似乎恒定在约0.5%。相比之下，妊娠性绒毛膜癌的特征是血清β-hCG绝对水平比妊娠期间观察到的最大值高3至280倍，且β-hCG与hCG的比值极高。在完全性葡萄胎中，该比值介于正常妊娠和绒毛膜癌之间。游离β-hCG与hCG的比值很有可能区分正常妊娠与完全性葡萄胎（p<10⁻⁸）、葡萄胎与绒毛膜癌（p<10⁻⁴）以及绒毛膜癌与正常妊娠（p<10⁻⁸）。最后，通过高灵敏度hCG免疫放射分析方法（<0.02 ng/ml）发现，该分析方法可预测妊娠性绒毛膜癌患者肿瘤的早期复发。