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Elevation of Free ß Subunit of Human Choriogonadotropin and Core ß Fragment of Human Choriogonadotropin in the Serum and Urine of Patients with Malignant Pancreatic and Biliary Disease¹

Department of Obstetrics and Gynecology, Haartmaninkatu 2, SF-00290 Helsinki [H. A., U-H. S.], and Department of Surgery, Kasarmikatu 11-13 [C. H., P. R.], Helsinki University Central Hospital, SF-00130 Helsinki, Finland

Human choriogonadotropin (hCG), its free ß subunit (ßhCG), and the core ßhCG fragment (cßhCG) were measured by highly sensitive time-resolved immunofluorometric assays in the serum and urine of 29 patients with pancreatic cancer, 7 patients with biliary cancer, and 45 patients with benign pancreatic or biliary diseases. The results were compared with those of an age- and sex-matched reference population of nonpregnant women and men. Of the various forms of hCG assayed in serum, ßhCG showed the best diagnostic accuracy, and cßhCG was the best marker in urine. Elevated serum concentrations of ßhCG were observed in 72% of the patients with pancreatic cancer, in 6 of 7 patients with biliary cancer, and in 9% of those with benign disorders. The serum concentrations of cßhCG were elevated in 45%, 57%, and 2%, respectively, and those in urine in 55%, 71%, and 11%, respectively. The molar concentrations of cßhCG in serum were mostly lower than those of ßhCG. Thus ßhCG secreted into serum appears to be the main source of cßhCG in urine. Provided that they are measured by sufficiently sensitive and specific assays, ßhCG in serum and cßhCG in urine appear to be useful markers for pancreatic and biliary cancer.

¹ Supported by grants from the Finnish Cancer Foundation, the Finnish Social Security Institution, the Sigrid Juselius Foundation, and the Magnus Ehrnrooth Foundation. Parts of the results have been presented as an abstract at the Fifth World Congress on Gestational Trophoblastic Diseases, London, October 3–5, 1990.

² To whom requests for reprints should be addressed, at the Clinical Laboratory, Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Haartmaninkatu 2, SF-00290 Helsinki, Finland

Received 12/31/91. Accepted 6/23/92.

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