RADIOIMMUNOASSAY OF HUMAN CHOEIONIC GONADOTROPIN (HCG) AND ALPHA FETOPROTEIN (αFP) IN THE MANAGEMENT OF HEPATOBLASTOMA

Abstract

Sensitive and specific radioimmunoassays for HCG and αFP were used to monitor treatment of 3 boys with hepatoblastoma. In the first, chemotherapy and radiation produced an initial rise in HCG from 162 to 12,000 mIU/ml, followed by a decline to 70 mIU/ml. Testosterone values reflected the changes in HCG, but αFP remained stable at 515,000 ng/ml. After surgery HCG fell to <2 mIU/ml and αFP was normal (<20 ng/ml.) Tumor markers have not recurred in 2 yrs. A second boy had no virilization, no HCG and αFP between 33 and 145 ng/ml during unsuccessful chemotherapy. The third patient had mild virilization, HCG of 15 mIU/ml and αFP of 1,818,000 ng/ml at diagnosis. HCG disappeared post surgery, but αFP has persisted at 20,000 ng/ml and metastases have appeared during 1 year of chemotherapy. These findings demonstrate a wide divergence between HCG and αFP levels at diagnosis and during treatment. Transient increases during chemotherapy may indicate release of marker from damaged tumor cells and not treatment failure. Prompt decline and prolonged absence of both markers following surgery suggests a good prognosis.