人绒毛膜促性腺激素的游离β亚单位对滋养细胞疾病的诊断价值的研究
摘要
目的 探讨人绒毛膜促性腺激素游离β亚单位(F-β-HCG)及F-β-HCG／HCG百分比在滋养细胞疾病诊断中的价值。
方法 应用化学发光免疫测定法测定15例葡萄胎患者清宫前，20例侵蚀性葡萄胎患者及17例绒癌患者未治疗前血清HCG、β-HCG及F-β-HCG浓度，计算F-β-HCG／HCG、F-β-HCG／β-HCG的百分比，并且在治疗期间动态监测其变化。选择同期正常早孕患者40例作为对照组。
结果 F-β-HCG在正常早孕妇女、葡萄胎患者、侵蚀性葡萄胎及绒癌患者的血清平均值分别为24±11ng／ml、715+397ng／ml、69±11ng／ml、245+229ng／ml。F-β-HCG／HCG及F-β-HCG／β-HCG的百分比在恶性滋养细胞肿瘤患者显著高于葡萄胎及正常早孕妇女(P＜0.001)。该比值在绒癌患者又高于侵蚀性葡萄胎患者。
结论 F-β-HCG可作为妊娠后判断是正常妊娠，还是滋养细胞疾病的一项监测指标；F-β-HCG／HCG，F-β-HCG／β-HCG的百分比可反应滋养细胞疾病的恶性程度。
Objective To determine the value of serum F-β-HCG and F-β-HCG to HCG ratio in evaluation of gestational trophoblastic disease.
Methods Chemiluminescent immunoassy was used to measure the levels of HCG, β-HCG and F-β-HCG in 15 hydatidiform mole patients before utenne evacuation, 20 untreated invasive mole and 17 untreated Choriocarcinoma patients. Serial measurement of serum F-β-HCG and HCG was performed on serum samples from the patients throughout their clinical course. Meanwhile, serum samples were obtained from 40 normal pregnant women (6 to 12 gestational weeks) as control.
Results The average concentrations of F-β-HCG in normal pregnancy, Hydatidiform moles, invasive mole and Choriocarcinoma were 24±11ng/ml, 715± 397ng/ml , 69±11ng/ml and 245±229ng/ml respectively. F-β-HCG/HCG and F-β-HCG/β-HCG ratios were significant higher in malignant trophoblastic tumour than that in hydatidiform mole and normal pregnancy group (P<0.001). Meanwhile, this ratio was higher in Choriocarcinoma than in invasive mole.
Conclusion F-β-HCG could be used as a criterion for differentiation of normal pregnancy to gestational trophoblastic disease. F-β-HCG /HCG and F-βHCG /β-HCG ratios may be useful as a supplemental tumor marker in the evaluation of trophoblastic disease
方法 应用化学发光免疫测定法测定15例葡萄胎患者清宫前，20例侵蚀性葡萄胎患者及17例绒癌患者未治疗前血清HCG、β-HCG及F-β-HCG浓度，计算F-β-HCG／HCG、F-β-HCG／β-HCG的百分比，并且在治疗期间动态监测其变化。选择同期正常早孕患者40例作为对照组。
结果 F-β-HCG在正常早孕妇女、葡萄胎患者、侵蚀性葡萄胎及绒癌患者的血清平均值分别为24±11ng／ml、715+397ng／ml、69±11ng／ml、245+229ng／ml。F-β-HCG／HCG及F-β-HCG／β-HCG的百分比在恶性滋养细胞肿瘤患者显著高于葡萄胎及正常早孕妇女(P＜0.001)。该比值在绒癌患者又高于侵蚀性葡萄胎患者。
结论 F-β-HCG可作为妊娠后判断是正常妊娠，还是滋养细胞疾病的一项监测指标；F-β-HCG／HCG，F-β-HCG／β-HCG的百分比可反应滋养细胞疾病的恶性程度。
Objective To determine the value of serum F-β-HCG and F-β-HCG to HCG ratio in evaluation of gestational trophoblastic disease.
Methods Chemiluminescent immunoassy was used to measure the levels of HCG, β-HCG and F-β-HCG in 15 hydatidiform mole patients before utenne evacuation, 20 untreated invasive mole and 17 untreated Choriocarcinoma patients. Serial measurement of serum F-β-HCG and HCG was performed on serum samples from the patients throughout their clinical course. Meanwhile, serum samples were obtained from 40 normal pregnant women (6 to 12 gestational weeks) as control.
Results The average concentrations of F-β-HCG in normal pregnancy, Hydatidiform moles, invasive mole and Choriocarcinoma were 24±11ng/ml, 715± 397ng/ml , 69±11ng/ml and 245±229ng/ml respectively. F-β-HCG/HCG and F-β-HCG/β-HCG ratios were significant higher in malignant trophoblastic tumour than that in hydatidiform mole and normal pregnancy group (P<0.001). Meanwhile, this ratio was higher in Choriocarcinoma than in invasive mole.
Conclusion F-β-HCG could be used as a criterion for differentiation of normal pregnancy to gestational trophoblastic disease. F-β-HCG /HCG and F-βHCG /β-HCG ratios may be useful as a supplemental tumor marker in the evaluation of trophoblastic disease
引文
1. Lee Tyrey. Human Chorionic Gonadotropin: Properties and Assay Methods. Seminars in Oncology 1995;22:121-129
2. Morgan FJ, Canfield RE. Nature of the subunits of human chorinic gonadotropin. Endocrinology 1971;88:1045-1053
3. Vaitukaitis JL, Braunstein GD, Ross GT. A radioimmunoassay which specifically measures human chorionic gonadotropin in the presence of human luteinizing hormone. Am J Obstet Gynecol 1972;113:751-758
4. Badonnel Y, Barbe F, Legagneur H et al. Inhibin as a marker for hydatidiform mole:a comparative study with the determinations of intact human chorionic gonadotrophin and its free-β subunit. Clinical Endocrinology 1994;41:155-162
5．免疫测定进展．上海免疫学杂志，1999：19(2)：
2. Morgan FJ, Canfield RE. Nature of the subunits of human chorinic gonadotropin. Endocrinology 1971;88:1045-1053
3. Vaitukaitis JL, Braunstein GD, Ross GT. A radioimmunoassay which specifically measures human chorionic gonadotropin in the presence of human luteinizing hormone. Am J Obstet Gynecol 1972;113:751-758
4. Badonnel Y, Barbe F, Legagneur H et al. Inhibin as a marker for hydatidiform mole:a comparative study with the determinations of intact human chorionic gonadotrophin and its free-β subunit. Clinical Endocrinology 1994;41:155-162
5．免疫测定进展．上海免疫学杂志，1999：19(2)：