CLINICAL STUDY OF TESTICULAR TUMOR

Positive cases of serum human chorionic gonadotropin (hCG) have been increased in patients with pure seminoma due to the progress of methods of measuring serum hCG. But the positive ratio and the value of serum hCG in pure seminoma cases are lower than those of non-seminoma cases. The relationship between the pathological type of testicular tumor and the hCG levels in both serum and tumor tissue was investigated, and clinical usefulness of the serum hCG levels as a tumor marker of pure seminoma was discussed. The materials were 19 pure seminomas, 14 non-seminomas and 11 normal testes as controls.HCG and hCG-β in tumor tissue extracts and in the serum of blood from the spermatic and peripheral veins were measured by radioimmunoassay (RIA). The tissue content of hCG and hCG-β were 276.7±136.1mIU/g·tissue and 16.5±3.20ng/g·tissue, respectively, in pure seminoma; 224, 376±91, 619mIU/g·tissue and 4, 608±1, 817ng/g·tissue, respectively, in non-seminoma including choriocarcinoma component; 1, 807±1, 428mIU/g·tissue, and 37.0±11.2ng/g·tissue, respectively, in non-seminoma including seminoma component but not including choriocarcinoma component; 20.4±3.1mIU/g·tissue and 1.27±0.38ng/g·tissue, respectively, in normal testes, (each M±SE).The tissue content of hCG-β in pure seminoma is significantly higher than that in normal testis (p<0.01) and significantly lower than that in non-seminoma including choriocarcinoma component. There was no significant difference in hCG and hCG-β in tumor tissue extracts between pure seminoma and non-seminoma including seminoma component, but not including choriocarcinoma component, and between normal control and non-seminoma (yolk sac tumor, mature treatoma, epidermoid cyst) excluding both seminoma and choriocardinoma component. In all patients with pure seminoma, serum hCG or hCG-β of the spermatic vein was higher than those of the peripheral vein.These results strongly suggest that all pure seminomas produce hCG-β like substances. With more precision in measuring hCG, serum hCG may be a clinically useful tumor marker of all pure seminoma. Furthermore, measurement of hCG in the tumor tissue may assist pathological diagnosis of testicular tumors.