Schwangerschaftsprotein 1 (SP1) in serum and cerebrospinal fluid of patients with gestational trophoblastic disease

The beta subunit of human chorionic gonadotrophin (beta-hCG) and Schwangerschaftsprotein 1 (SP1) were measured by radioimmunoassay in the serum and cerebrospinal fluid (CSF) of 46 postmolar and postpartum patients who developed gestational trophoblastic disease. There was a significant correlation between beta-hCG and SP1 serum levels. The mean serum SP1 level in high-risk patients was significantly higher than that in low-risk patients. There was a significant correlation between serum and CSF beta-hCG levels. The ratio of serum to CSF beta-hCG levels was low in the three patients with clinical evidence of intracranial metastasis. SP1 was present in the CSF of only one of these three patients, but it could be detected in the CSF of another four patients without clinical evidence of metastases in the central nervous system. The two low-risk patients with SP1 present in the CSF showed poor response to intramuscular methotrexate.     

Concentrations of SP1 and beta-hCG in serum and cerebrospinal fluid and concentrations of hCG in urine in patients with trophoblastic tumour

Using immunological techniques urinary hCG, pregnancy-specific beta 1-glycoprotein (SP1) and beta-subunit of hCG (beta-hCG) levels were measured in the serum and cerebrospinal fluid of patients with trophoblastic tumours. After removal of hydatidiform moles, urinary hCG, beta-hCG and SP1 levels were similar, but SP1 levels tended to exceed serum beta-hCG levels. SP1 usually disappeared first. In patients with metastatic choriocarcinoma, SP1 levels appeared to be lower than beta-hCG values in serum and cerebrospinal fluid, but urinary hCG, beta-hCG and SP1 concentrations all decreased during chemotherapy. Measurements of SP1 levels may well be useful in the monitoring of patients being treated for trophoblastic tumours.     

Concentrations of SP1 and ß-hCG in serum and cerebrospinal fluid and concentrations of hCG in urine in patients with trophoblastic tumour

Archives of Gynecology and Obstetrics - Using immunological techniques urinary hCG, pregnancy-specific ß-glycoprotein (SP1) and ß-subunit of hCG (ß-hCG) levels were measured in the...     

Studies on the half-life of Schwangerschaftsprotein 1 (SP1)

Summary. Schwangerschaftsprotein 1 (SP1) was measured in 10 women at intervals after delivery of the placenta. SP1α decreased more sharply than SP1β and showed evidence of a two-compartmental distribution in the mother. Trace amounts of both proteins could still be detected 5 weeks after delivery. It is concluded that the findings support the view that the two proteins are separate biological entities and that there is a possibility that SP1β is generated from SP1α in the maternal compartment.     

Anti-HLA antibodies detected in the serum of patients with gestational trophoblastic tumors (choriocarcinomas and invasive moles)

Four patients with Choriocarcinomas and nineteen patients with invasive moles were analyzed seriately for anti-HLA antibodies. One serum out of four with Choriocarcinomas and 6 sera out of 19 with invasive moles demonstrated monospecific anti-HLA antibodies and persisted as long as each patient was treated by chemotherapy. One serum which was not determined to be anti-HLA antibody was checked with the serum of one patient with choriocarcinoma. The relationship between the antibodies and tumor growth or response to chemotherapy was studied clinically, but no definite relationship was established. In the present studies, antigenicity of the trophoblastic cell itself was not established.     

Reproductive performance of patients with gestational trophoblastic disease in Hong Kong

The reproductive performance of 110 patients who had had gestational trophoblastic disease was reviewed. There were 160 pregnancies and their outcomes were similar to that of the general population. The subfertility rate was also comparable to the general population. The high rate of failure of contraception resulting in a high rate of conception during the first year of follow-up warrants special attention. Reasons for the high failure rate and ways of prevention are discussed. Reasons for the deliberate delay in attempts to conceive in patients after the full year of postmolar human chorionic gonadotropin (hCG) surveillance were explored.     

Choriocarcinoma and gestational trophoblastic disease

Gestational trophoblastic disease (GTD) encompasses a unique group of uncommon but interrelated conditions derived from placental trophoblasts. For the purposes of discussion GTD is the appropriate collective name for hydatidiform mole, whereas the term gestational trophoblastic neoplasia (GTN) is reserved for cases with persistent human chorionic gonadotropin (hCG) titer elevation after evacuation of hydatidiform mole, metastatic disease, or choriocarcinoma. Although the pathology and clinical behavior of CM and PM are different, the initial management of both conditions is surgical evacuation by suction curettage, determination of the baseline, and follow-up with (hCG) titers. There are guidelines for risk-factor scoring and a staging system that classifies untreated patients into distinct prognostic categories so that treatment outcomes can be objectively compared. The rates of GTN and choriocarcinoma are decreasing and survival has dramatically improved.     

Value of Schwangerschaftsprotein 1 (SP1) and pregnancy-associated plasma protein-A (PAPP-A) in the clinical management of threatened abortion

Pregnancy-associated plasma protein-A (PAPP-A) and Schwangerschaftsprotein 1 (SP1) levels were measured in single serum samples from 60 patients admitted with vaginal bleeding in the first 14 weeks of pregnancy. When based on ultrasound diagnoses the prediction of non-viability (the predictive value) was 97% for SP1 and 84% for PAPP-A. Whereas the prediction of viability (above -2SD of the normal range) with SP1 was 88% the value with PAPP-A was only 57%; the poorer result obtained with PAPP-A probably reflects its longer half-life. Pregnancy outcome is not related to the duration of bleeding.     

妊娠滋养细胞疾病误诊问题

妊娠滋养细胞疾病常与妊娠有关联,故需与流产、异位妊娠、双胎妊娠等相鉴别;而妊娠滋养细胞肿瘤因有病灶转移甚至破裂,可有脑血管意外、急腹症等表现,另外,还常需与人流或药流后、产后胎盘残留、宫角妊娠等相鉴别。     

Epidemiology of gestational trophoblastic disease

The epidemiology of gestational trophoblastic disease is not well understood. Methodologic problems with published reports limit the interpretation of incidence data, although the frequency of hydatidiform mole appears to be about one per 1000 pregnancies. No consistent temporal trends in rates of either hydatidiform mole or choriocarcinoma are evident. Hydatidiform mole appears to be caused by abnormal gametogenesis and fertilization. Age, ethnicity, and a history of hydatidiform mole appear to be important risk factors for hydatidiform mole. Age, ethnicity, a history of hydatidiform mole or fetal wastage, and ABO blood group interactions appear to be important risk factors for choriocarcinoma. Future studies should focus on the mechanisms by which these risk factors influence gametogenesis, fertilization, and malignant transformation of trophoblastic tissue.     

Recent advances in gestational trophoblastic disease

Recent advances have increased our understanding of gestational trophoblastic disease, and epidemiologic studies have demonstrated that there are important differences in risk factors for complete and partial mole. Complete moles are now increasingly being diagnosed in the first trimester, affecting their clinical presentation and pathologic characteristics. While important advances have been made in chemotherapy, it is now recognized that etoposide is associated with a risk of second tumors. Several studies have advanced understanding of the molecular biology of gestational trophoblastic disease, and this is important for the eventual development of new and innovative therapy.