Sisinni Lorenza, Landriscina Matteo
Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture, PZ, Italy.
Clinical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71100, Foggia, Italy.
Adv Exp Med Biol. 2015;867:159-76. doi: 10.1007/978-94-017-7215-0_11.
Tumor markers are biological substances that are produced/released mainly by malignant tumor cells, enter the circulation in detectable amounts and are potential indicators of the presence of a tumor. The most useful biochemical markers are the tumor-specific molecules, i.e., receptors, enzymes, hormones, growth factors or biological response modifiers that are specifically produced by tumor cells and not, or minimally, by the normal counterpart (Richard et al. Principles and practice of gynecologic oncology. Wolters Kluwer Health, Philadelphia, 2009). Based on their specificity and sensitivity in each malignancy, biomarkers are used for screening, diagnosis, disease monitoring and therapeutic response assessment in clinical management of cancer patients.This chapter is focused on human chorionic gonadotropin (hCG), a hormone with a variety of functions and widely used as a tumor biomarker in selected tumors. Indeed, hCG is expressed by both trophoblastic and non-trophoblastic human malignancies and plays a role in cell transformation, angiogenesis, metastatization, and immune escape, all process central to cancer progression. Of note, hCG testing is crucial for the clinical management of placental trophoblastic malignancies and germ cell tumors of the testis and the ovary. Furthermore, the production of hCG by tumor cells is accompanied by varying degrees of release of the free subunits into the circulation, and this is relevant for the management of cancer patients (Triozzi PL, Stevens VC, Oncol Rep 6(1):7-17, 1999).The name chorionic gonadotropin was conceived: chorion derives from the latin chordate meaning afterbirth, gonadotropin indicates that the hormone is a gonadotropic molecule, acting on the ovaries and promoting steroid production (Cole LA, Int J Endocrinol Metab 9(2):335-352, 2011). The function, the mechanism of action and the interaction between hCG and its receptor continue to be the subject of intensive investigation, even though many issues about hCG have been well documented (Tegoni M et al., J Mol Biol 289(5):1375-1385, 1999).
肿瘤标志物是主要由恶性肿瘤细胞产生/释放的生物物质，以可检测的量进入循环系统，是肿瘤存在的潜在指标。最有用的生化标志物是肿瘤特异性分子，即受体、酶、激素、生长因子或生物反应调节剂，它们由肿瘤细胞特异性产生，而正常细胞不产生或极少产生（理查德等人。《妇科肿瘤学原理与实践》。Wolters Kluwer Health出版社，费城，2009年）。根据其在每种恶性肿瘤中的特异性和敏感性，生物标志物用于癌症患者临床管理中的筛查、诊断、疾病监测和治疗反应评估。本章重点介绍人绒毛膜促性腺激素（hCG），这是一种具有多种功能的激素，在特定肿瘤中广泛用作肿瘤生物标志物。事实上，hCG在滋养层和非滋养层人类恶性肿瘤中均有表达，并在细胞转化、血管生成、转移和免疫逃逸中发挥作用，所有这些过程都是癌症进展的核心。值得注意的是，hCG检测对于胎盘滋养层恶性肿瘤以及睾丸和卵巢生殖细胞肿瘤的临床管理至关重要。此外，肿瘤细胞产生hCG的同时会伴随不同程度的游离亚基释放到循环系统中，这与癌症患者的管理相关（特里奥zzi PL，史蒂文斯VC，《肿瘤学报告》6(1):7 - 17，1999年）。绒毛膜促性腺激素这个名称的由来是：绒毛膜源自拉丁语chordate，意为胎盘，促性腺激素表明该激素是一种促性腺分子，作用于卵巢并促进类固醇生成（科尔LA，《国际内分泌与代谢杂志》9(2):335 - 352，2011年）。尽管关于hCG的许多问题已有充分记录，但hCG的功能、作用机制及其与受体之间的相互作用仍然是深入研究的主题（特戈尼M等人，《分子生物学杂志》289(5):1375 - 1385，1999年）。
