Levels of alpha-subunits of gonadotropins can be increased in Zollinger-Ellison syndrome, both in patients with malignant tumours and with apparently benign disease.
To evaluate the value of intact hCG, the beta-subunit of hCG and the common alpha-subunit of the glycoprotein hormones as tumour markers in patients with gastrinomas, we investigated 30 patients with the Zollinger-Ellison syndrome. Fifty-seven percent of the patients with malignant disease (N = 7) and 45% of those with active and apparently benign disease (N = 20) had raised values of circulating alpha-subunit. Detectable levels of hCG or hCG-beta were found in 7 patients of whom 4 had malignant disease. Radical tumour resection in 2 patients resulted in normalisation of elevated levels of alpha-subunit, and in one patient who developed metastases, the alpha-subunit values became elevated simultaneously. By chromatographic studies we found that the alpha-subunit-like reacting substance in serum eluted as the normal free alpha-subunit in 8 patients, but in one patient with metastatic disease we found evidence for production of a larger molecular form of alpha-subunit. The results indicate that the common alpha-subunit is a valuable tumour marker in patients with gastrinomas, whereas hCG-beta is only seldomly elevated. Single estimates of any of the hormonal fragments seem not to relate with malignancy, whereas a rise in alpha-subunit concentration in some patients may be related to the development of malignancy.
Bardram
L
L
Department of Surgical Gastroenterology C, Righospitalet, University of Copenhagen, Denmark.
Agner
T
T
Hagen
C
C
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006063:Chorionic Gonadotropin / Q000097:blood*; D002850:Chromatography, Gel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015043:Zollinger-Ellison Syndrome / Q000097:blood*
D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin