Serum Müllerian Inhibiting Substance/anti-Müllerian hormone levels in patients with adult granulosa cell tumors directly correlate with aggregate tumor mass as determined by pathology or radiology.
OBJECTIVE
Granulosa cell tumors (GCTs) comprise 2-5% of ovarian tumors. Serum Müllerian Inhibiting Substance (MIS, also known as anti-Müllerian hormone, or AMH) levels have been validated as a marker of GCT recurrence and progression. There has been little correlation between serum MIS/AMH levels and several clinical parameters in GCTs, including tumor burden. We have performed a retrospective review correlating aggregate tumor mass as reported by pathologic examination or by radiology with serum MIS/AMH levels drawn on the date of examination.


METHODS
We retrospectively identified 32 GCT patients at our institution over the last 15 years who had serum MIS/AMH measurements. Patients who had serum MIS/AMH measurements within three days of surgery or on the same day as abdominal computerized tomography scan (CT) or magnetic resonance imaging (MRI) were further evaluated.


RESULTS
We found a significant direct correlation between patient serum MIS/AMH levels and gross aggregate tumor mass determined by pathology (slope=15.4+/-6.06, r=0.65, p<0.04) or by radiographic aggregate tumor mass for all data points identified (slope=0.07+/-0.03, r=0.33, p<0.04) and after correcting for selection bias (slope=1.45+/-0.17, r=0.93, p<0.01). We also identified a significant difference between serum MIS/AMH levels between samples drawn the same day as negative and positive abdominal CT or MRI scans (8.16+/-1.54 vs. 158.7+/-32.2 ng/ml, p<0.0001).


CONCLUSIONS
These data indicate a significant direct correlation between serum MIS/AMH levels and both gross and radiographic aggregate tumor mass in GCT patients. Together with the current literature, the present data argue for a more prominent role for serum MIS/AMH in the management of GCTs.
Pediatric Surgical Research Laboratories, Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge St., CPZN 6.220, Boston, MA 02114, USA.
Henry L
HL
Chang
Nima
N
Pahlavan
Elkan F
EF
Halpern
David T
DT
MacLaughlin
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D006106:Granulosa Cell Tumor / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology; D011379:Prognosis; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies
D054304:Anti-Mullerian Hormone