Nishimura R, Koizumi T, Yokotani T, Taniguchi R, Morisue K, Yoshimura M, Hiranmoy D, Yamaguchi S, Nakagawa T, Hasegawa K, Yasui H
Hyogo Institute of Clinical Research, 13-70 Kitaoji-cho, Akashi 673, Japan.
Int J Gynaecol Obstet. 1998 Apr;60 Suppl 1:S29-S32. doi: 10.1016/S0020-7292(98)80002-7.
We analyzed immunoreactive hCG/hCG β (IR-β) in the sera and urine of patients with trophoblastic diseases and non-trophoblastic tumors by using enzyme immunoassays (EIAs) specific for intact hCG, free hCG β, and β-core fragment of hCG (β-CF). In trophoblastic diseases, while intact hCG and free hCG β were contained in both serum and urine, the β-CF could be detected only in the urine of the patients. The relative contribution of the β-CF to the total urinary IR-β accounted for about 30-50% in normal early pregnancy and hydatidiform mole, and more than 60% in choriocarcinoma. We conclude that intact hCG should be measured in the serum rather than in the urine as a tumor marker for trophoblastic dieseases, and suggested that the ratios of intact hCG, free hCG β, and β-CF to each other may be useful indices in the differential diagnosis of trophoblastic diseases. Ectopic IR-β was also investigated in the sera and urine of the patients with cervical, endometrial, ovarian, lung, and bladder carcinomas. We found that even when IR-β could not be detected in the serum, the urine of the same patients with cancer often contained the significant amounts of IR-β. The chromatographic study indicated that these urinary IR-β were essentially attributed to β-CF, leading to the evaluation of urinary β-CF as a tumor marker. The positive rated of urinary β-CF were 48% for cervical, 38% for endometrial, and 84% for ovarian, 40% for lung, and 42% for bladder carcinomas. We conclude that ectopic production of hCG β by non-trophoblastic tumors is not a rare phenomenon and it can be recognized as a tumor marker when β-CF is measured in urine of the patients.
我们采用针对完整hCG、游离hCGβ和hCGβ核心片段（β-CF）的酶免疫分析法（EIA），分析了滋养层疾病和非滋养层肿瘤患者血清及尿液中的免疫反应性hCG/hCGβ（IR-β）。在滋养层疾病中，血清和尿液中均含有完整hCG和游离hCGβ，但仅在患者尿液中可检测到β-CF。在正常早孕和葡萄胎中，β-CF对总尿IR-β的相对贡献约为30%-50%，在绒毛膜癌中则超过60%。我们得出结论，作为滋养层疾病的肿瘤标志物，应检测血清中的完整hCG而非尿液中的，并且完整hCG、游离hCGβ和β-CF之间的比值可能是滋养层疾病鉴别诊断的有用指标。我们还对宫颈癌、子宫内膜癌、卵巢癌、肺癌和膀胱癌患者的血清和尿液中的异位IR-β进行了研究。我们发现，即使在血清中未检测到IR-β，同一癌症患者的尿液中通常也含有大量的IR-β。色谱研究表明，这些尿IR-β主要归因于β-CF，从而促使将尿β-CF评估为肿瘤标志物。尿β-CF的阳性率在宫颈癌中为48%，子宫内膜癌中为38%，卵巢癌中为84%，肺癌中为40%，膀胱癌中为42%。我们得出结论，非滋养层肿瘤异位产生hCGβ并非罕见现象，当检测患者尿液中的β-CF时，可将其识别为肿瘤标志物。
