Lempiäinen Anna, Sankila Anna, Hotakainen Kristina, Haglund Caj, Blomqvist Carl, Stenman Ulf-Håkan
Department of Clinical Chemistry, Helsinki University Central Hospital Laboratory Division (HUSLAB) and Helsinki University, Helsinki, Finland.
Department of Pathology, Helsinki University Central Hospital Laboratory Division (HUSLAB), Helsinki, Finland.
Urol Oncol. 2014 Jul;32(5):727-34. doi: 10.1016/j.urolonc.2013.11.007. Epub 2014 Feb 4.
We have shown that most patients with seminomas have elevated serum concentrations of the free β subunit of human chorionic gonadotropin (hCGβ) and that in nonseminomatous testicular cancer, most of the hCG in the serum is hyperglycosylated (hCG-h). However, the tissue expression of hCG-h or hCGβ in germ cell tumors (GCTs) has not been reported. Our objective was to study the expression and diagnostic value of hCG-h and hCGβ in testicular GCTs.
We studied the immunohistochemical expression of hCG, hCG-h, hCGβ, and the free α subunit of hCG (hCGα) in GCTs from 154 patients. We compared the tissue expression with serum concentrations and evaluated the correlation between staining intensity, established prognostic variables, and outcome.
The expression varied between tumor types. All forms of hCG, including hCG-h, were detected in embryonal carcinomas (22%) and mixed GCTs (48%). Polyclonal hCG and monoclonal hCGβ antibodies detected immunoreactivity in some seminomas (7%). No form of hCG was found in spermatocytic seminomas, pure teratomas, or a yolk sac tumor. The serum concentrations correlated with the corresponding tumor expression. The staining intensities of hCG, hCGβ, hCG-h, and hCGα correlated with disease stage but not significantly with relapse, disease-related mortality, or progression-free survival.
Trophoblastic tissue expresses hCG, hCG-h, and free subunits together whereas seminoma tissue occasionally expresses hCGβ. This difference might aid in differential diagnosis of some difficult-to-classify cases.
我们已经表明，大多数精原细胞瘤患者血清中人绒毛膜促性腺激素游离β亚基（hCGβ）浓度升高，并且在非精原细胞瘤性睾丸癌中，血清中的大多数hCG是高糖基化的（hCG-h）。然而，hCG-h或hCGβ在生殖细胞肿瘤（GCT）中的组织表达尚未见报道。我们的目的是研究hCG-h和hCGβ在睾丸GCT中的表达及诊断价值。
我们研究了154例患者GCT中hCG、hCG-h、hCGβ和hCG游离α亚基（hCGα）的免疫组化表达。我们将组织表达与血清浓度进行比较，并评估染色强度、既定预后变量和结局之间的相关性。
表达因肿瘤类型而异。在胚胎癌（22%）和混合性GCT（48%）中检测到所有形式的hCG，包括hCG-h。多克隆hCG和单克隆hCGβ抗体在一些精原细胞瘤（7%）中检测到免疫反应性。在精母细胞性精原细胞瘤、纯畸胎瘤或卵黄囊瘤中未发现任何形式的hCG。血清浓度与相应的肿瘤表达相关。hCG、hCGβ、hCG-h和hCGα的染色强度与疾病分期相关，但与复发、疾病相关死亡率或无进展生存期无显著相关性。
滋养层组织同时表达hCG、hCG-h和游离亚基，而精原细胞瘤组织偶尔表达hCGβ。这种差异可能有助于某些难以分类病例的鉴别诊断。
