Gestational trophoblastic neoplasia coexisting with cervical carcinoma: A case report / Philippine Journal of Obstetrics and Gynecology

@#Gestational trophoblastic neoplasia (GTN) with a concurrent cervical malignancy is very rare, making the case both a diagnostic dilemma and a therapeutic challenge. Currently, there has only been one reported case worldwide. We present a case of GTN Stage I:11 with non‑keratinizing squamous cell carcinoma of the cervix Stage II‑B. Initial treatment, in the form of chemotherapy, was directed toward the GTN, as this appeared to be the more aggressive disease. Surgery was not feasible during diagnosis due to the cervical carcinoma. However, the GTN proved resistant to chemotherapy due to the increasing beta human chorionic gonadotropin titers. An attempt to decrease the size of the cervix for surgery to be possible through chemoradiation was instituted, but due to complications and tumor progression to the lungs, she succumbed to the malignancy.

Association between adverse obstetric outcomes and abnormal maternal serum markers in the second trimester screening / 上海交通大学学报（医学版）

Objective · To evaluate the association between the abnormal maternal serum markers of alpha fetoprotein (AFP), human chorionic gonadotrophin (hCG) and unconjugated estriol (uE3) in the second trimester screening and the adverse obstetric outcomes other than trisomy 21 (T21),trisomy 18 (T18) and open neural tube defects (ONTD), and to provide local data for supporting evidence based clinical managements. Methods · A retrospective cohort study was performed in the women who received second trimester maternal serum screening in the International Peace Maternal and Child Health Hospital between 2012 and 2014, with naturally conceived singleton pregnancies. Obstetric outcomes were followed up by searching electronic medical records within the hospital. Abnormal level of marker was defined as a MOM value ≥ 99th (P99) or ≤ 1st percentile (P1) of the overall screened population. Incidence of an adverse obstetric outcome was compared between the groups with abnormal markers and the control with all markers in normal. Results · ① A total of 25616 pregnancies were included in this study, in which 4526 were identified as having various adverse obstetric outcomes. Among them 4143 pregnancies were with isolated and 383 pregnancies were with co-occurring two or more adverse outcomes. ② When compared to pregnancies with normal levels of all three serum markers, pregnancies with decreased AFP or decreased hCG did not show associations with any adverse obstetric outcomes. However, pregnancies with increased AFP, increased hCG or decreased uE3 were at increased risk for a variety of abnormal pregnancy outcome. In 18 pregnancies with an outcome of fetal chromosomal abnormalities other than T21 and T18, 9 presented with either increased AFP, increased hCG or decreased uE3, with relative risk ratios of 13.33、35.00 and 59.00, respectively. ③ The performance of those markers tended to be improved in a subset of adverse obstetric outcomes, including low birth weight

Quality control of human chorionic gonadotrophin subunit dissociation / 药学学报

Human chorionic gonadotrophin (hCG), a glycohormone widely used in treatment of infertility, is a heterodimer composed of an alpha-and a beta-subunit. The heterodimer could be dissociated during production and storage with an impact on its bioactivity. A CE-SDS method for quantitative analysis of hCG subunit dissociation was established in this study by optimization of a variety of method conditions including sample preparation buffer compositions, incubation temperature, separation voltage, and capillary temperature. This method was validated for good sensitivity, linearity, precision, and accuracy for both α-and β-subunit. CE-SDS also showed much better precision and accuracy than SDS-PAGE. The method was successfully used in both recombinant hCG (r-hCG) produced by cell culture and hCG (u-hCG) derived from urine. The CE-SDS method was used in the study of hCG development and stability. Therefore, it is an useful tool for the quality control of hCG.

Secondary male hypogonadism induced by sellar space-occupying lesion: Clinical analysis of 22 cases / 中华男科学杂志

<p><b>Objective</b>To analyze the clinical characteristics of secondary male hypogonadism induced by sellar space-occupying lesion, explore its pathogenesis, and improve its diagnosis and treatment.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data about 22 cases of secondary male hypogonadism induced by sellar space-occupying lesion, reviewed related literature, and investigated the clinical manifestation, etiological factors, and treatment methods of the disease. Hypogonadism developed in 10 of the patients before surgery and radiotherapy (group A) and in the other 12 after it (group B). The patients received endocrine therapy with Andriol (n=7) or hCG (n=15).</p><p><b>RESULTS</b>The average diameter of the sellar space-occupying lesions was significantly longer in group A than in B (［2.35±0.71］ vs ［1.83±0.36］ cm, P<0.05) and the incidence rate of prolactinomas was markedly higher in the former than in the latter group (60% vs 0, P<0.01). The levels of lutein hormone (LH), follicle stimulating hormone (FSH) and testosterone (T) were remarkably decreased in group B after surgery and radiotherapy (P<0.01). Compared with the parameters obtained before endocrine therapy, all the patients showed significant increases after intervention with Andriol or hCG in the T level (［0.78±0.40］ vs ［2.71±0.70］ ng/ml with Andriol; ［0.93±0.44］ vs ［3.07±0.67］ ng/ml with hCG) and IIEF-5 score (5.00±2.61 vs 14.50±3.62 with Andriol; 5.36±1.82 vs 15.07±3.27 with hCG) (all P<0.01). The testis volume increased and pubic hair began to grow in those with hypoevolutism. The patients treated with hCG showed a significantly increased testis volume (P<0.01) and sperm was detected in 7 of them, whose baseline testis volume was markedly larger than those that failed to produce sperm (［11.5±2.3］ vs ［7.5±2.3］ ml, P<0.01). Those treated with Andriol exhibited no significant difference in the testis volume before and after intervention and produced no sperm, either.</p><p><b>CONCLUSIONS</b>Hypothyroidism might be attributed to surgery- or radiotherapy-induced damage to the pituitary tissue, space-occupying effect of sellar lesion, and hyperprolactinemia. Both Andriol and hCG can improve the T level and erectile function, but the former does not help spermatogenesis.</p>

Induction of ovulation in quarter horse mares through the use of deslorelin acetate and human chorionic gonadotrophin (hCG)

The aim this study was to compare two protocols of induction for ovulation by desloreline acetate and hCG in Quarter Horse mares. The choice of the animals was based on the observations by the estrus, by rectal palpation of the ovaries and by ultrassonography of the follicular dynamics. After estrus detection and follicle control, the measurement of the follicles and the classification of uterus were carried out. The animals that had dominant follicle (diameter more than 35 mm) and swollen uterus were used. In these conditions, the mares received hCG or desloreline acetate. Once ovulation occurred, the artificial insemination was carried. Two groups were performed: G1 (20 animals) received 1.5 mg desloreline acetate and G2 (20 animals) received 1700 IU of hCG. Following 6h intervals, the control follicular was performed by ultrasonography. The follicular average diameter was 42.6 cm for the groups and set up a score of 0 to 3 of uterine edema displayed by the device as well as the time of ovulation. In conclusion, the desloreline acetate showed better performance than hCG, because the ovulation was induced in less time (nine hours than hCG) (p<0.05).The pregnancy rate was 80 and 75 percent, respectively in G1 and G2.

A Case of Trophoblastic Tumor Associated with Papillary Thyroid Cancer / 대한내과학회지

Thyroid cancer is one of the most common endocrine malignancies. It is known that thyroid cancer can develop during reproductive periods, possibly due to the effects of sex hormones and growth factors such human chorionic gonadotrophin (HCG). Some data suggest that elevated HCG levels during pregnancy or gestational trophoblastic disease can stimulate thyroid cellular proliferation and promote cancer formation; however, a case of papillary thyroid cancer accompanied by a gestational trophoblastic tumor has not been reported. Here, we report the case of a 44-year-old woman with papillary thyroid cancer during treatment for a gestational trophoblastic tumor.

Preparation and purification of monoclonal antibodies against human chorionic gonadotrophin / 中国生化药物杂志

Purpose To prepare monoclonal antibody against hCG. Methods Balb/c mice were immunized with hCG, and spleen cells from the mice were fused with myeloma cells SP2/0 at ratio of 5:1. Positive clones were screened by indirect enzyme-linked-immunoadsorbent assay (ELISA) ,then the clones were subcloned by limiting dilution and amplified further. After intraperitoneal injection of hybridoma cells, mouse ascites antibody was prepared. Titres and specificity of the ascites antibody were identified and determined by indirect ELISA. The ascites were purified by protein A affinity chromatography. Results Two strains of hybridoma cell lines obtained could secrete MAb stably. The titre of MAb of cell culture supernate is more than 10~(-3), and the titre of prepared ascites MAb is more than 10~(-7).The purity of the obtained monoclonal antibody was more than 98% and recovery reached 75 % after purification. Conclusion The obtained two strains of hybridoma cell lines can secrete MAb stably. The monoclonal antibodies can be used in the research of early pregnancy and tumor diagnosis .

Adjusting effect of human chorionic gonadotrophin in the vascular endothelial growth factor in rabbit phallus with hypospadias / 中华泌尿外科杂志

Objective To study the function of human chorionie gonadotrophin(HCG) in adjus-ting the vascular endothelial growth factor(VEGF) in rabbit phallus with hypospadias. Methods Rabbit hypospadias mode was made by Finasteride. After the spontaneous delivery, 35 rabbits were divided into 5 groups with 7 in each group. Four groups accepted HCG intramuscular injection for 7 consecutive days with dosages of 100,200,400 and 600 U, respectively. The control group accepted the same dosage of saline injection. Another 7 normal rabbits were used as normal controls without in-tervention. After 3 weeks, the rabbit phallus tissue was collected and the VEGF levels were detected by ELISA. Results Rabbits with hypospadias accepted HCG 100, 200, 400, 600 U injection had the phallus tissue VEGF level of 5.00±2.37,5.63±1.73, 10.35±2.34 and 16.91±2.34 pg/ml, respectively. While the rabbits accepted saline injection had VEGF levels of 3.99±1.19 pg/ml. The normal rabbit phallus tissue contained VEGF level of 14.82±3.32 pg/ml. There were significant differences between normal group and the rabbits accepted HCG 100, 200, 400 U injection (P＜ 0.05), but there was no difference with the rabbits accepted HCG 600 U injection (P＞0.05). The VEGF level in rabbits accepted 400 U HCG injection had significant difference with rabbits accepted 100, 200, 600 U HCG (P＜0.05). The VEGF levels in rabbits accepted 100, 200 U HCG injection had no difference with rabbits accepted saline injection(P＞0.05). Conclusions The VEGF in rabbit phallus with hypospadias is decreased. HCG of certain dosage could increase VEGF level in rabbit phallus with hypospadias.

The Immunoexpressions and Prognostic Significance of Inhibin Alpha and Beta Human Chorionic Gonadotrophins (hCG) in Breast Carcinomas / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Pregnancy and hCG treatments are considered essential for inhibiting breast cancer. The effect of hCG is accompanied by the synthesis of inhibin, a transforming growth factor involved in cell differentiation and proliferation. Inhibin is considered a tumor suppressor, but its role in the breast is unclear. The aim of this study was to determine the frequency and tissue distribution of the expressions of inhibin-alpha and beta-hCG in breast cancer, and their prognostic relevance with other biological parameters. MATERIALS AND METHODS: 334 of formalin-fixed, paraffin embedded tissue blocks were selected, and then immunostained for inhibin-alpha and beta-hCG. The inhibin-alpha expression was compared with those of beta-hCG, ER, PR and HER-2/neu, as well as the tumor characteristics and recurrences. RESULTS: Inhibin-alpha and beta-hCG were expressed in 87 (26.0%) and 44 cases (13.2%), respectively. Inhibin-alpha was found in 25.1% of infiltrating ductal carcinomas (67/267), 26.7% of intraductal carcinomas (8/30), 33.3% of lobular tumors (3/9), 80.0% of apocrine carcinomas (4/5) and 21.7% of the other types (5/23). Inhibin-alpha was correlated with beta-hCG (p<0.0001), PR (p=0.010) and HER-2/ neu (p=0.021). HCG was focally expressed in the cytoplasm of the conventional types, but the apocrine type displayed diffusely intense cytoplasmic staining, which correlated with histological tumor types (p<0.001). CONCLUSION: Inhibin was significantly correlated with the expressions of hCG, PR and HER-2/neu. Therefore, it might be a useful marker in the prevention and hormonal treatment of breast cancer, such as hCG and progesterone. HCG was expressed significantly higher in the apocrine type than the conventional types, suggesting it can be a useful adjunct in differentiating other cancer types.

Immunohistochemical localization of beta human chorionic gonadotrophin (beta-hCG) in breast carcinomas and its prognostic significance / 한국유방암학회지

PURPOSE: The early parity that reduces the risk of developing breast cancer indicates that hormonal conditions might play an important role in its prevention. Both pregnancy and hCG treatment are considered essential for the inhibiting breast cancer. The purpose of this study is to investigate the incidence of beta-hCG expression in breast cancer and to access its relationship with the other biologic parameters. METHODS: Three hundred and thirty-four cases of formalin-fixed, paraffin embedded tissue blocks were selected, and then immunostained for beta-hCG. HCG expression was compared with ER, PR, HER-2/neu, the tumor characteristics and recurrence. RESULTS: Forty-four cases (13.2%) showed positivity for beta-hCG. HCG positivity was observed in 12.0% of infiltrating ductal carcinomas (32/267), 13.3% of intraductal carcinomas (4/30), 11.1% of infiltrating lobular carcinomas (1/9), 80.0% of apocrine carcinomas (4/5) and 13.0% of the other types of carcinomas (3/23). HCG expression was statistically significant between the histological tumor types (p=0.001), but not with the patient's age (p=0.696), tumor grade (p=0.255), tumor size (p=0.510), lymph node status (p=0.620), ER (p=0.498), PR (p=0.421), HER-2/neu oncogene expression (p=0.483) and tumor recurrence (p=0.181). HCG was focally expressed in the cytoplasm of the conventional types, but the apocrine type displayed diffusely intense cytoplasmic staining. CONCLUSION: Although beta-hCG expression was statistically insignificant between the tumor recurrence (p=0.181) and biological parameters, it may be of interest in the future to correlate the presence of beta-hCG expression with a possible therapeutic response in patients of the breast cancer.

A Case of Primary Gastric Choriocarcinoma Presenting with Amenorrhea / Journal of the Korean Cancer Association, 대한암학회지

Primary gastric choriocarcinomas are very rare, and their prognosis is extremely poor. A 37-year-old woman presented with amenorrhea, vaginal spotting and severe nausea, which mimicked a pregnancy and gestational trophoblastic disease. The serum level of the beta-subunit of human chorionic gonadotrophin (beta-hCG) was significantly increased. An endoscopic biopsy of the stomach mass showed the features of a choriocarcinoma, with marked anaplasia and necrosis. Immunohistochemical staining for beta-hCG showed positive results in the choriocarcinoma. Chemotherapy for the choriocarcinoma was administered, but she died 8 months following diagnosis.

Effect of human chorionic gonadotrophin on TGF-?_3 expression in JEG-3 cell line / 中国免疫学杂志

Objective:To explore whether human chorioic gonadotrophin(hCG) might change the invasiveness of trophoblast by regulating the prodution of TGF-?3. Methods: The effect of hCG on TGF-?3 mRNA expression in JEG-3 cells was investigated by employing the semi-quantiative method of reverse transcription polymerase chain reaction(RT-TCR). Results:TGF-?3 was shown to be expressed in JEG-3 cells. After incubated with 0,50,500,5 000,25 000 mU/ml hCG for 48 hours respectively, the expression of TGF-?3 in JEG-3 cells increased gradually with the concentration of hCG increased. Additionally,TGF-?3 mRNA expression in JEG-3 cells incubated with 25 000 mU/ml hCG experienced a significant induction at 30 h point which was followed by a less significant decrease.Conclusion:The autocrine of TGF-?3 might be involved in the effect of hCG on trophoblast or trophoblast-derived choriocarcinoma cell invasiveness.

Advances in research of the relationship between ectopic hCG and malignant tumor / 中国癌症杂志

Ectopic human chorionic gonadotrophin (hCG) is an autocrine hormone expressed by most malignant tumor cells. Increasing data recently showed that the expression pattern and biological properties of ectopic hCG was significantly different from that of the normal hCG secreted by trophoblastic cells. Evidence from different research groups strongly indicated that there was a direct relationship between the expression of ectopic hCG and the development of malignant tumor. Ectopic hCG may play a key role in regulation of tumor growth,metastasis and immune tolerance versus malignant tumor. The advances in the research of the molecular biologic characteristics and functions of ectopic hCG are reviewed and evaluated. [

Screening for chromosomal abnormalities with three maternal serum markers / 中国医师杂志

0.05).But the detection rates of them were all higher than that of AFP alone(P

Construction and eukaryotic expression of recombinant plasmid ?hCG-CTP/pcDNA3 / 第三军医大学学报

Objective To clone and express the gene fragment of human chorionic gonadotrophin-? carboxyl terminal peptide (?hCG-CTP) and to explore the possibility of mouse immunocontraception with ?hCG-CTP gene fragment. Methods ?hCG-CTP gene fragment was chemically synthesized. ?hCG-CTP DNA fragment was digested with EcoRⅠ and BamHⅠ together, and then ligated to eukaryotic expression vector pcDNA3 which was also digested under the same condition. Product of ligation reaction was transformed into Escherichia coli DH5?. Recombinant plasmid pcDNA3/?hCG-CTP was then transfected into COS-7 cells with liposome. The expression of ?hCG-CTP gene fragment in mammalian animal cells was detected by immunohistochemistry. Results Double restriction enzyme digestion and subsequent sequencing of recombinant plasmids confirmed the correctness of the recombinant plasmids. Recombinant plasmid pcDNA3/?hCG-CTP was transfected into COS-7 cells with liposome, and transient expression of ?hCG-CTP protein was obtained. Conclusion Recombinant plasmid pcDNA3/?hCG-CTP which can express ?hCG-CTP gene in mammalian animal cells has been constructed correctly. The expressed product ?hCG-CTP can be recognized by antibody against ?hCG.