Utility of assay of alpha subunit of human chorionic gonadotropin in management of gestational, trophoblastic malignancies.
All patients who were treated with chemotherapy for malignant gestational trophoblastic neoplasms at the Southeastern Regional Trophoblastic Disease Center and who experienced remission during the period January 1, 1978, through December 31, 1979, were studied in an attempt to determine if the application of an assay for the alpha subunit of human chorionic gonadotropin (hCG-alpha) could predict those patients who would have recurrences. For each patient, the first three weekly serum samples with undetectable HCG by the hCG beta-subunit radioimmunoassay as well as the two preceding samples with detectable hCG were assayed in a homologous hCG-alpha assay. Results reaffirm previous data that the latter assay is useful only in patients receiving oral contraceptives for suppression of pituitary gonadotropin secretion. No patient who has remained in remission had a mean level of hCG-alpha in the three hCG-negative samples greater than 1 ng/ml. Of those patients who had recurrences of trophoblastic disease, two of three had hCG-alpha levels greater than 1.5 ng/ml. Although these data are preliminary, they suggest that the routine measurement of hCG-alpha in patients successfully treated for trophoblastic disease may aid in identification of a group of patients who require additional or more intensive follow-up and/or additional chemotherapy to prevent later recurrences.
D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D003276:Contraceptives, Oral / Q000627:therapeutic use; D005260:Female; D015292:Glycoprotein Hormones, alpha Subunit; D006065:Gonadotropins, Pituitary / Q000037:antagonists & inhibitors; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood; D010446:Peptide Fragments / Q000097:blood*; D011247:Pregnancy; D011379:Prognosis; D012075:Remission, Spontaneous; D014328:Trophoblastic Neoplasms / Q000097:blood*; D014594:Uterine Neoplasms / Q000097:blood*
D006063:Chorionic Gonadotropin; D003276:Contraceptives, Oral; D015292:Glycoprotein Hormones, alpha Subunit; D006065:Gonadotropins, Pituitary; D010446:Peptide Fragments