Detection of beta-human chorionic gonadotropin expressing cells by nested reverse transcriptase-polymerase chain reaction in the peripheral blood stem cells of patients with advanced germ cell tumor.
OBJECTIVE
We investigated whether peripheral blood stem cells (PBSCs) were contaminated by tumor cells.


METHODS
A total of 13 patients with advanced testicular cancer underwent PBSC transplantation at our institute. Nested reverse transcriptase-polymerase chain reaction using primers specific for beta-human chorionic gonadotropin (beta-HCG) or alpha-fetoprotein (AFP) detected 1 beta-HCG or AFP producing cell in 1 x 10(6) PBSCs.


RESULTS
Although AFP messenger (m) RNA was not identified in any of the 13 patients, beta-HCG mRNA was detected in 7. All patients with beta-HCG mRNA in PBSCs had elevated serum beta-HCG before treatment. Three patients with a normal beta-HCG range before treatment did not have beta-HCG mRNA in the PBSCs. The serum beta-HCG level in the patients whose PBSCs were contaminated with tumor cells was significantly higher than in patients whose PBSCs contained no tumor cells. Four of the 7 patients with beta-HCG mRNA in PBSCs eventually died of cancer, whereas those whose PBSCs were not contaminated with tumor cells survived without disease.


CONCLUSIONS
Patients with elevated serum beta-HCG levels are likely to have PBSCs contaminated by tumor cells. Moreover, the prognosis of patients with tumor cells in the PBSCs is poor.
Hara
Isao
I
Department of Urology, Kobe University School of Medicine, Kobe, Japan.
Yamada
Yuji
Y
Miyake
Hideaki
H
Hara
Shoji
S
Gotoh
Akinobu
A
Fujisawa
Masato
M
Okada
Hiroshi
H
Arakawa
Soichi
S
Kamidono
Sadao
S
D000293:Adolescent; D000328:Adult; D001781:Blood Component Removal; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D017931:DNA Primers; D018237:Germinoma / Q000097:blood* / Q000473:pathology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000097:blood* / Q000473:pathology
D018997:Chorionic Gonadotropin, beta Subunit, Human; D017931:DNA Primers