Kinugasa M, Nishimura R, Koizumi T, Morisue K, Higashida T, Natazuka T, Nakagawa T, Isobe T, Baba S, Hasegawa K
Department of Obstetrics and Gynecology, Hyogo Medical Center for Adults, Akashi.
Jpn J Cancer Res. 1995 Aug;86(8):783-9. doi: 10.1111/j.1349-7006.1995.tb02469.x.
Ectopic production of the immunoreactive beta-subunit of human chorionic gonadotropin (IR-hCG beta) by gynecologic malignancies has been well recognized, but IR-hCG beta has not yet been established as a clinically useful tumor marker, except for germ cell tumors. We measured the concentrations of IR-hCG beta-related molecules, intact hCG, free hCG beta, and beta-CF, in the sera and urine of patients with various gynecologic cancers (cervical, endometrial, and ovarian cancers) to assess their clinical usefulness as a tumor marker in comparison with serum tumor markers such as CEA, SCC, CA125, and CA19-9. The highest incidence of IR-hCG beta was obtained in the assay for beta-CF in the urine, with positive rates of 47.7% (94 of 197) for cervical, 37.8% (14 of 37) for endometrial, and 84.4% (38 of 45) for ovarian cancers with a cut-off value of 0.2 ng/mg of creatinine. In cervical cancer, there was no significant correlation between the concentrations of urinary beta-CF and serum SCC, and 57.9% (114 of 197) of the patients were detected by the combination assay of these tumor markers. Serial determination in 22 cervical cancer patients with elevated urinary beta-CF level prior to therapy showed that its level decreased after successful treatment, but 4 of 5 patients with persistent or recurrent disease had elevated levels of urinary beta-CF. All of the ovarian cancer patients examined were detected by the combination assay of urinary beta-CF and serum CA125. The levels of urinary beta-CF showed little correlation with those of the serum tumor markers, indicating the usefulness of the combination assay of urinary beta-CF with serum tumor markers for detecting cervical and ovarian cancers.
妇科恶性肿瘤异位产生人绒毛膜促性腺激素免疫反应性β亚基（IR-hCGβ）已得到充分认识，但除生殖细胞肿瘤外，IR-hCGβ尚未被确立为一种临床有用的肿瘤标志物。我们测定了各种妇科癌症（宫颈癌、子宫内膜癌和卵巢癌）患者血清和尿液中IR-hCGβ相关分子、完整hCG、游离hCGβ和β-CF的浓度，以评估它们作为肿瘤标志物与血清肿瘤标志物如CEA、SCC、CA125和CA19-9相比的临床实用性。在尿液β-CF检测中，IR-hCGβ的发生率最高，宫颈癌阳性率为47.7%（197例中的94例），子宫内膜癌为37.8%（37例中的14例），卵巢癌为84.4%（45例中的38例），肌酐截断值为0.2 ng/mg。在宫颈癌中，尿β-CF浓度与血清SCC之间无显著相关性，57.9%（197例中的114例）的患者通过这些肿瘤标志物的联合检测被发现。对22例治疗前尿β-CF水平升高的宫颈癌患者进行连续测定，结果显示成功治疗后其水平下降，但5例持续或复发疾病患者中有4例尿β-CF水平升高。所有接受检查的卵巢癌患者均通过尿β-CF与血清CA125的联合检测被发现。尿β-CF水平与血清肿瘤标志物水平相关性较小，表明尿β-CF与血清肿瘤标志物联合检测对检测宫颈癌和卵巢癌有用。
