Serum and urinary levels of beta human chorionic gonadotrophin in patients with transitional cell carcinoma

Abstract

Summary Serum and early morning urine specimens were obtained from 62 patients. The levels of beta human chorionic gonadotrophin (BhCG) in both serum and urine were estimated simultaneously in all cases. At the time of estimation 43 patients had transitional cell carcinoma of the bladder, one had transitional cell carcinoma of the renal pelvis and three had carcinoma in situ (two of whom also had overt carcinoma). Raised serum and urinary levels were found in only three patients, all of whom had poorly differentiated or metastatic transitional cell carcinoma of the bladder. This observation is in accordance with previous studies. In one of these patients, who underwent transurethral resection of her bladder tumour, the urinary levels returned to within normal limits post resection. An Recently it was postulated that the secretion of hCG and its beta subunit (BhCG) was an innate property of bladder epithelium, whether it be neoplastic or non neoplastic (Iles et al., 1987). This would suggest that BhCG levels may be measurable in the serum and urine of patients with tumours of better differentiation.The present study was undertaken to assess the merit of using BhCG levels as a tumour marker in bladder cancer. Materials and methods

Different hCG assays to measure ectopic hCG secretion in bladder carcinoma patients

“…There is accumulating evidence indicating that the isolated production of free fl-hCG may be associated with aggressive trophoblastic and non-trophoblastic malignancies (Cole et al, 1993;Marcillac et al, 1992;Rinker et al, 1989;Saller et al, 1990). Like others, (Iles et al, 1989;McLoughlin et al, 1991;Smith et al, 1994), we found no correlation between the hCG concentration and the tumour grade. Moreover, there seems to be no correlation between the hCG concentration and tumour DNA-ploidy and S-phase fraction according to other studies (Fossa et al, 1993).…”

“…As we commented earlier, because the aim of our study was to compare the efficiency of different hCG assay, we specifically selected patients with raised hCG values and, therefore, the diagnostic sensitivities obtained were higher than those of other authors (Dexeus et al, 1986;Iles et al, 1989;McLoughlin et al, 1991;Smith et al, 1994). Kit 1 and kit hCG fraction.…”

Ectopic human chorionic gonadotrophin (HCG) production: is the detection by serum analysis of HCG of clinical relevance in transitional cell carcinoma of the bladder?

“…While this appears to conflict with other studies [11,12,13] that have shown a link with raised serum PHCG, metastases and poorly differentiated disease, there seems to be little doubt that PHCG is secreted more frequently by poorly differentiated TCC and that an elevated PHCG level would indicate a more aggressive tumour and possibly indicate unknown metastases. The majority of the patients had welldifferentiated tumours and the individual with a very high serum level had a grade 1-11 tumour.…”

“…Ectopic production of PHCG [12] reported only 9% (6/62) of patients with raised PHCG levels in their series but of these only three were widespread and poorly differentiated. Therefore an elevated serum PHCG may indicate patients with a poorer prognosis and more widespread disease [11,12].…”

Das Urothelkarzinom mit trophoblastischer Differenzierung

“…Die Prog no se ist im Ver gleich zum mar ker ne ga ti ven Kar zi nom deut lich schlech ter. Die Be stim mung von β-HCG als Tu mor-oder Pro gno se mar ker in der Be hand lung des Uro thelkar zi noms wird der zeit, ob wohl in der Li te ra tur auf die erhöh te ma lig ne Po tenz die ser Uro thelkar zinom va ri an te hin ge wie sen wird [6,7], routi ne mä ßig nicht emp foh len [10].…”