Combination assay of urinary beta-core fragment of human chorionic gonadotropin with serum tumor markers in gynecologic cancers.
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.
Kinugasa
M
M
Department of Obstetrics and Gynecology, Hyogo Medical Center for Adults, Akashi.
Nishimura
R
R
Koizumi
T
T
Morisue
K
K
Higashida
T
T
Natazuka
T
T
Nakagawa
T
T
Isobe
T
T
Baba
S
S
Hasegawa
K
K
D014408:Biomarkers, Tumor / Q000032:analysis* / Q000097:blood / Q000652:urine; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000652:urine*; D002850:Chromatography, Gel / Q000379:methods; D003911:Dextrans; D005260:Female; D005833:Genital Neoplasms, Female / Q000097:blood* / Q000652:urine*; D006801:Humans; D007202:Indicators and Reagents; D046911:Macromolecular Substances; D012016:Reference Values
D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D003911:Dextrans; D007202:Indicators and Reagents; D046911:Macromolecular Substances; C025614:sephadex