人绒毛膜促性腺激素的凝集素层析在判断滋养细胞肿瘤中的应用

APPLICATION OF LECTIN CHROMATOGRAPHY OF HUMAN CHORIONIC GONADOTROPIN IN THE DIAGNOSIS OF TROPHOBLASTIC CELL TUMORS

目的 研究恶性滋养细胞肿瘤分泌的人绒毛膜促性腺激素（ｈＣＧ） 中的异常糖链结构应用于临床诊断的可能性。 方法 测定２２ 例正常孕妇（ＮＰ） 、１２ 例良性葡萄胎（ＨＭ） 、１８ 例侵蚀性葡萄胎（ＩＨＭ） 和１７ 例绒毛膜癌（ＣＣ） 患者一次性晨尿中ｈＣＧ 的含量及其在蔓陀罗凝集素（ＤＳＡ） 亲和柱上的结合率。 结果 滋养细胞疾病病人一次性尿中的ｈＣＧ 含量与ＮＰ 没有差别。ＨＭ 尿中ｈＣＧ 的ＤＳＡ 结合率与ＮＰ 无异，而ＩＨＭ 与ＣＣ 尿中ｈＣＧ 的ＤＳＡ 结合率则明显高于ＮＰ或ＨＭ，ＩＨＭＣＣ和ＮＰＨＭ 两组间没有交叉重叠。ＣＣ尿中ｈＣＧ 的ＤＳＡ 结合率更高于ＩＨＭ 组，但无统计学差别。ＩＨＭ 或ＣＣ 经化疗后，尿中ｈＣＧ 含量降低，但ｈＣＧ的ＤＳＡ 结合率的降低在统计学上较含量降低更为显著。 结论 尿ｈＣＧ 的ＤＳＡ 结合率可用于恶性滋养细胞疾病的诊断及疗效认定。

To study the possibility of applying the reported structural abnomality of sugar chains in human Chorionic Gonadotropin(hCG) from malignant trophoblastic cell tumors for clinical use.METHODS The hCG contents and its binding rate(%) to Datura stramonium agglutinin(DSA)affinity column in the morning urine sample were determined in 22 cases of normal pregnancy(NP),12 cases of hydatidiform mole(HM),18 cases of invasive mole(IHM) and 17 cases of chonocarcinoma(CC).RESULTS There was no difference between the urine hCG contents in a single moring sample from NP and all trophoblastic tumors.The DSA binding rates of urine hCG from HM and NP were identical,while the hCG binding rates of IM and CC were significantly higher than those of NP and HM.The DSA binding rates of urine hCG from IHM CC groups were not over laped with those from NP HM groups. The hCG binding rate of CC group was higher than that of IHM group,but not statistically significant.The urine hCG contents and DSA binding rates of hCG were both decreased after the chemical therapy for IHM and CC patients,but the decrease of DSA binding rate was more significant than the decrease of hCG content when analyzed with statistics.CONCLUSIONS The DSA binding rate of urine hCG may be used in the diagnosis and follow up of the therapeutic effect in malignant trophoblastic tumors.