Shaarawy M, Darwish N A, Abdel-Aziz O
Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Egypt.
J Soc Gynecol Investig. 1996 Jan-Feb;3(1):39-46. doi: 10.1016/1071-5576(95)00036-4.
To investigate serum interleukin-2 (IL-2) and soluble interleukin-2 receptor (SIL-2) levels in gestational trophoblastic diseases (GTD).
Sixty-six patients with GTDs and 23 first-trimester healthy pregnant women (controls) participated in this study. According to the World Health Organization scoring system, GTDs were subgrouped into the following groups: 30 hydatidiform mole spontaneous regression (HMSR), 12 postmolar gestational trophoblastic tumors of high risk (PMHR), 14 low-risk choriocarcinomas, and ten high-risk choriocarcinomas. Before treatment, a blood sample from each case was assayed for beta-hCG by radioimmunoassay, IL-2 by IRMA, and SIL-2R by enzyme-linked immunosorbent assay. Follow-up beta-hCG assays were carried out at weekly intervals after treatment for 3 months, then monthly for 1 year.
Serum IL-2 levels in all subgroups of GTD were significantly lower than that of controls. Meanwhile, there were concomitant significant elevations of serum SIL-2R, showing mean rises of 3.86-fold, 3.9-fold, twofold, and 6.1-fold for cases of HMSR, PMHR, low-risk choriocarcinoma, and high-risk carcinoma, respectively. All cases of high-risk choriocarcinoma revealed abnormally high SIL-2R values. There was a significant positive correlation between serum beta-hCG and SIL-2R concentrations.
The possible causes of IL-2 decreases and SIL-2R increases may indicate a defective immune response in GTDs. The high correlation between SIL-2R level and tumor burden suggests the use of serum SIL-2R assay for disease monitoring: SIL-2R is indirect marker of tumor activity, and it is useful in the differential diagnosis of GTD because a normal value of serum SIL-2R excludes high-risk cases of choriocarcinoma.
探讨妊娠滋养细胞疾病（GTD）患者血清白细胞介素-2（IL-2）及可溶性白细胞介素-2受体（SIL-2）水平。
66例GTD患者和23例孕早期健康孕妇（对照组）参与本研究。根据世界卫生组织评分系统，GTD患者被分为以下几组：30例葡萄胎自然消退（HMSR）、12例高危葡萄胎后妊娠滋养细胞肿瘤（PMHR）、14例低危绒毛膜癌和10例高危绒毛膜癌。治疗前，采用放射免疫法检测各病例血样中的β-hCG，采用免疫放射分析法检测IL-2，采用酶联免疫吸附测定法检测SIL-2R。治疗后3个月每周进行1次β-hCG随访检测，之后1年每月检测1次。
GTD各亚组血清IL-2水平均显著低于对照组。同时，血清SIL-2R显著升高，HMSR、PMHR、低危绒毛膜癌和高危绒毛膜癌病例的平均升高倍数分别为3.86倍、3.9倍、2倍和6.1倍。所有高危绒毛膜癌病例的SIL-2R值均异常升高。血清β-hCG与SIL-2R浓度之间存在显著正相关。
IL-2降低和SIL-2R升高的可能原因提示GTD存在免疫反应缺陷。SIL-2R水平与肿瘤负荷之间的高度相关性表明可采用血清SIL-2R检测进行疾病监测：SIL-2R是肿瘤活性的间接标志物，因其血清SIL-2R正常可排除高危绒毛膜癌病例，故对GTD的鉴别诊断有帮助。
