Abstract
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 additional three patients had elevations of serum BhCG. Two of these three patients had poorly differentiated transitional cell carcinoma present at the time of estimation and one had no sign of recurrence. Using immunoperoxidase staining a retrospective study was undertaken to stain all available sections belonging to patients studied to observe whether BhCG was being produced by the respective tumours. Twelve well differentiated, nine moderately well differentiated and seven poorly differentiated specimens were available. In no case was evidence of BhCG production demonstrated in these tumours despite its presence being demonstrable in positive controls. We confirm the production of BhCG associated with bladder tumours, a feature correlated with poorer differentiation. Studies employing larger patient numbers are necessary to clarify the role of this tumor marker in patients with well differentiated bladder tumours.
Highlights
A serum and an early morning urine sample were obtained from 57 patients prior to undergoing diagnostic or check cystoscopy
Seventeen patients had no sign of recurrence at the time of beta human chorionic gonadotrophin (BhCG) estimation
Three of the 15 patients (20%) with poorly differentiated transitional cell carcinomas had both raised serum and urinary levels of BhCG. This compares to the report of Dexeus et al (1986) who demonstrated that 38% of patients with advanced transitional cell carcinoma of the bladder had some degree of elevation of BhCG in their serum
Summary
A serum and an early morning urine sample were obtained from 57 patients prior to undergoing diagnostic or check cystoscopy. An additional five patients with advanced or metastatic, poorly differentiated bladder cancer who were referred for consideration for systemic chemotherapy were similarily studied. A radioimmunoassay technique using a polyclonal antibody of rabbit origin directed against Beta subunit of hCG was employed (sensitive to a level of approximately 1 IU/1-1). This assay reacts with the Beta core fragment, the free Beta subunit and the Beta component of the intact hCG molecule. Specimens were analysed in batches and stored at 4°C. Merthiolate was added to urine specimens prior to storage.
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Published Version
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