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, Akashi, Japan.
Int J Gynaecol Obstet. 1998 Apr;60 Suppl 1:S29-32.
We analyzed immunoreactive hCG/hCGbeta (IR-beta) 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 beta, and beta-core fragment of hCG (beta-CF). In trophoblastic diseases, while intact hCG and free hCGbeta were contained in both serum and urine, the beta-CF could be detected only in the urine of the patients. The relative contribution of the beta-CF to the total urinary IR-beta 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 diseases, and suggested that the ratios of intact hCG, free hCGbeta, and beta-CF to each other may be useful indices in the differential diagnosis of trophoblastic diseases. Ectopic IR-beta 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-beta could not be detected in the serum, the urine of the same patients with cancer often contained the significant amounts of IR-beta. The chromatographic study indicated that these urinary IR-beta were essentially attributed to beta-CF, leading to the evaluation of urinary beta-CF as a tumor marker. The positive rated of urinary beta-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 beta by non-trophoblastic tumors is not a rare phenomenon and it can be recognized as a tumor marker when beta -CF is measured in urine of the patients.
我们采用针对完整hCG、游离hCGβ和hCG的β核心片段（β-CF）的酶免疫测定法（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在总尿IR-β中的相对占比约为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，应检测血清而非尿液中的完整hCG，并建议完整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。我们还研究了宫颈癌、子宫内膜癌、卵巢癌、肺癌和膀胱癌患者血清及尿液中的异位IR-β。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往往含有大量IR-β。色谱研究表明，这些尿液中的IR-β主要归因于β-CF，从而将尿β-CF评估为一种肿瘤标志物。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，可将其识别为一种肿瘤标志物。
