Abstract
Introduction: Recent investigations indicate that in 50% of patients with gastric cancer, β-hCG-posiitive cells can be found in the tumour by immunohistochemical investigations. The objective of this study was to investigate how often β-hCG-immunoreactive gastric carcinomas were accompanied by an elevation in serum β-hCG, that could have been used as a course control variable. Methods: In 54 patients with gastric carcinoma a monoclonal antibody directed against β-hCG was used for immunohistochemical marking in the APAAP system. The evaluation was graded positive or negative. In parallel, serum β-hCG was determined preoperatively using an enzyme immunoassay (MEIA). Tumour stage, grading and tumour locallization were determinants in the evaluation. Results: We found that 41% (22 of 54) of the carcinomas induced a :positive immunohistochemical response to β-hCG, regardless of their location in the stomach. In relation to tumour stage, a positive β-hCG immunoreactivity was apparent in 27% (6/22) of tumours without lymph node or distant metastases (TI -4N0M0), in 54% (7/13) of tumours with lymph node and without distant metastases (T1−4N≥1 M0) and in 47% (9/35) of tumours with distant metastases. Poorly differentiated tumours (G3–4) were positive in 42% (15/36) and well-differentiated tumors (G1–2) in 39% (7/18) of cases. In only 1 patient was the β-hCG, level in serum elevated, however. Conclusions: β-hCG-Positive gastric carcinomas are found more frequently in advanced tumour stages and poorly differentiated carcinomas. These carcinomas, however, seem not to excrete β-hCG in sufficient amounts to produce measurable serum values. Therefore, β-hCG cannot be used a prognostic factor or for course control. The relevance of β-hCG expression of tumour cells to the patients' prognosis remains obscure.
Zusammenfassung
Einleitung: Nach neueren Untersuchungen ist davon auszugehen, daß bei des Hälfte von Patienten mit einem Magenkarzinom β-hCG-positive Zellen im Tumor immunhistochemisch gefunden werden können. Ziel war daher, systematisch zu untersuchen, inwieweit β-hCG-immunreaktive Magenkarzinome von einem Anstieg des Serum-β-hCG begleitet werden and dieses damit als Verlaufsparameter zur Verfügung steht. Methode: Bei 54 Patienten mit einem Magenkarzinom wurde zur immunhistochemischen Darstellung ein gegen β-hCG gerichteter monoklonaler Antikörper (Fa. Sigma, 1:100) im APAAP-System verwendet. Die Auswertung wurde nach positiver and negatives Reaktion graduiert. Parallel wurde im Serum des Patienten β-hCG präoperativ mit einem Enzymimmunoassay (MEIA, Fa. Abbot) bestimmt. Tumor-stadium, Grading and Tumor-lokalisation werden in die Auswertung mit einbezogen. Ergebnisse: Es wird bestätigt, daß 41% (22 von 54) des Karzinome, unabhängig von ihrer Lokalisation im Magen, eine positive immunhistochemische Reaktion gegen β-hCG auslösen. Es zeigte sich in Abhängigkeit vom Tumorstadium eine positive β-hCG-Immunreaktivität in 27% (6 von 22) des Tumoren ohne Lymphknoten- and Fernmetastasierung (T1–4 N0 M0), in 54% (7 von 13) des Tumoren mit Lymphknotenaber ohne Fernmetastasen (T1–4 N≥1 M0) und in 47% (9 von 35) des Tumoren mit Fernmetastasierung. Schlecht differenzierte Tumoren (G3–4) waren zu 42% (15 von 36) und gut differenzierte Tumoren (G1–2) nur zu 39% (7 von 18) positiv. Aber lediglich bei einer Patientin war der β-hCG-Spiegel im Serum erhöht. Zusammenfassung: Immunhistochemisch β-hCG-positive Magenkarzinome werden vermehrt bei fortgeschrittenem Tumorstadium und Schlecht differenzierten Karzinomen gefunden. Diese Kar zinome scheinen aber nicht in ausreichender Menge β-hCG ins Serum abzugeben, was zu serologisch meßbar erhöh-ten Werten führt. β-hCG im Serum kann daher nicht als Prognosefaktor bzw. zur Verlaufskontrolle herangezogen werden. Abzuwarten bleibt, inwieweit die β-hCG-Expression von Tumorzellen u. U. Einfluß auf die Propose der Patienten besitzt.
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Rau, B., Below, C., Haensch, W. et al. Zur Bedeutung von β-hCG im serum als tumormarker fur das magenkarzinom. Langenbecks Arch Chir 380, 359–364 (1995). https://doi.org/10.1007/BF00207226
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DOI: https://doi.org/10.1007/BF00207226