Papapetrou P D, Anagnostopoulos N I
J Clin Endocrinol Metab. 1985 Jun;60(6):1187-95. doi: 10.1210/jcem-60-6-1187.
One contraceptive tablet [(CP) containing 0.05 mg ethinyl estradiol and 0.5 mg norgestrel] was administered daily for 7 days to 38 hypergonadotropic postmenopausal women who had benign illness and to 34 similar women with cancer, in order to suppress the gonadotropins (LH and FSH) and their alpha-subunit secreted by the pituitary. LH, FSH, alpha-subunit, and hCG were measured using RIA in serum and urine extracts obtained before and on the seventh day of treatment. In the control group serum alpha-subunit fell to 53%, serum LH to 51%, serum FSH to 36%, urine alpha to 42%, urine hCG to 54%, urine LH to 53%, and urine FSH to 44% of their mean pretreatment values. Serum hCG was undetectable after treatment in all except 11 women in whom serum LH was not adequately suppressed. This fact and the significant positive linear correlation found between basal serum hCG and LH imply that serum hCG measured in postmenopausal women, with a RIA using the SB6 antiserum, is mainly cross-reacting LH. The suppression proved to be useful in the assessment of ectopic production of hCG and its alpha-subunit in the cancer group. Before treatment, 3 patients (8.8%) had elevated serum alpha-subunit levels, whereas after treatment 9 patients (26.5%) had elevated levels. For urine alpha-subunit 3 patients (8.8%) had elevated levels before and 13 (38.2%) after treatment. Six patients (17.7%) had elevated serum hCG levels before and 7 (20.6%) after treatment; however, for urine hCG, 3 patients (9%) had elevated levels before and 8 (24.2%) after treatment. Sephadex G-100 chromatography of urine extracts from two control women showed that the predominant form of free alpha-subunit secreted by the pituitary and excreted in the urine had lower apparent molecular weight after treatment with the CP. Chromatography of urine extracts from two cancer patients demonstrated that a small amount of beta-subunit of hCG produced ectopically by the tumor and excreted into the urine along with a core-type fragment of the hCG-beta was masked in the basal urine by cross-reacting LH; these ectopic peptides were not suppressible and could be specifically measured only after elimination of the urine LH by treatment with the CP. We conclude that administration of contraceptive steroid to post-menopausal women with cancer, by suppressing pituitary gonadotropin secretion and thus minimizing their interference in the hCG RIAs, can be useful in the detection of ectopic production of the hCG and its subunits.
对38名患有良性疾病的高促性腺激素绝经后女性和34名患有癌症的类似女性，每日服用1片避孕药片（[CP]，含0.05mg炔雌醇和0.5mg炔诺孕酮），持续7天，以抑制垂体分泌的促性腺激素（LH和FSH）及其α亚基。在治疗前和治疗第7天采集的血清和尿液提取物中，使用放射免疫分析法（RIA）测定LH、FSH、α亚基和hCG。在对照组中，血清α亚基降至其治疗前平均水平的53%，血清LH降至51%，血清FSH降至36%，尿α亚基降至42%，尿hCG降至54%，尿LH降至53%，尿FSH降至44%。除11名血清LH未得到充分抑制的女性外，所有女性治疗后血清hCG均检测不到。这一事实以及基础血清hCG与LH之间存在的显著正线性相关性表明，在绝经后女性中使用SB6抗血清通过RIA测定的血清hCG主要是交叉反应性LH。在癌症组中，这种抑制作用被证明有助于评估hCG及其α亚基的异位产生。治疗前，3例患者（8.8%）血清α亚基水平升高，而治疗后9例患者（26.5%）水平升高。尿α亚基方面，治疗前3例患者（8.8%）水平升高，治疗后13例（38.2%）升高。6例患者（17.7%）治疗前血清hCG水平升高，7例（20.6%）治疗后升高；然而，尿hCG方面，治疗前3例患者（9%）水平升高，治疗后8例（24.2%）升高。对两名对照女性的尿液提取物进行葡聚糖G - 100层析显示，垂体分泌并排泄到尿液中的游离α亚基的主要形式在服用CP治疗后表观分子量降低。对两名癌症患者的尿液提取物进行层析表明，肿瘤异位产生并与hCG - β的核心型片段一起排泄到尿液中的少量hCGβ亚基在基础尿液中被交叉反应性LH掩盖；这些异位肽不可被抑制，只有在通过服用CP消除尿液LH后才能特异性测定。我们得出结论，对患有癌症的绝经后女性给予避孕类固醇，通过抑制垂体促性腺激素分泌，从而最大限度减少其对hCG RIA的干扰，可有助于检测hCG及其亚基的异位产生。
