Beta human chorionic gonadotropin concentrations in serum of patients with pancreatic adenocarcinoma

Abstract

Background-Human chorionic gonadotropin (hCG) is normally produced and secreted by trophoblastic cells during pregnancy and from gestational trophoblastic neoplasms. It is also detected in ovarian, stomach, and colon adenocarcinomas, as well as in squamous cell carcinoma of the oesophagus. Recently, interest in its role in the pathogenesis of tumours has been enlivened after the presence of hCG in the cell membrane of several malignant cells was shown in vitro. Aims-To investigate the circulating concentrations of hCG in patients with exocrine pancreatic adenocarcinoma and to examine its potential prognostic value. Patients-Thirty six patients with exocrine pancreatic adenocarcinoma, 12 patients with chronic pancreatitis, and 21 healthy volunteers were studied. Methods-hCG serum concentrations were detected by the application of a radioimmunoassay technique. Results-Fifteen of 36 patients with pancreatic adenocarcinoma and only one patient with chronic pancreatitis had detectable plasma concentrations of hCG (p<0.01). The patients with circulating serum titres of hCG had a worse outcome compared with the group of hCG negative patients: the diVerence was statistically significant (p=0.01). Conclusion-More than 40% of pancreatic exocrine tumours produce hCG and its production is correlated with an adverse eVect on outcome. (Gut 1998;42:88-91)

Elevated Human Chorionic Gonadotrophin Due to Pancreatic Cancer

“…Forty-two percent ( 15 36 ) of patients with pancreatic carcinoma, 8% (1 12 ) of chronic pan-creatitis patients, and 0 21 normal individuals had de-tectable serum β hCG concentrations [2]. The production of β hCG was correlated with a more aggressive clinical course and a poorer prognosis with no systematic differences in the surgical procedures (p = 0.01) [2]. Alfthan et al found an even higher occurrence of elevated hCG levels.…”

“…Higher rates have been reported for pancreatic cancer patients. Studies using β hCG serum levels and immunohistochemical staining of tissue have demonstrated that β hCG is produced in 40% -56% in pancreatic cancers [2,3]. Syrigos et al examined serum concentrations of β hCG in randomly selected exocrine pancreatic adenocarcinoma patients.…”

“…Multiple cancers have been reported to secrete hCG, and more specifically β hCG [1]. Studies of elevated hCG in pancreatic cancer patients report an incidence of 40% -56% [2,3]. Serum β hCG testing done prior to the date of surgery (DOS) in cancer patients that are pre-or perimenopausal should be considered as it would allow time for a more definitive pregnancy evaluation to be performed.…”

The β subunit of human chorionic gonadotropin lacks specificity for malignant cells in serous effusions

“…Additionally, several carcinomas express hCG in addition to various germ cell tumors. The detection of hCG in serum in patients with carcinoma usually indicates a poor prognosis 5,6 or disease progression. 13 Similarly, tumors expressing hCG in colorectal adenocarcinoma suggests an aggressive course.…”

“…Several carcinomas, in addition to trophoblastic tumors, may express hCG, and detection of serum hCG in patients with such carcinomas generally portends a poor prognosis. [5][6][7] Additionally, detection of hCG in serous fluids using various laboratory assays has been associated with the presence of metastases in these specimens. 8,9 However, to date, no study has been published examining hCG as an immunostain in this cytologic setting.…”