血和脑脊液hCG比值对绒癌脑转移的诊断价值

本文报道血和脑脊液人绒毛膜促性腺激素(hCG)水平测定在诊断绒癌脑转移中的价值。临床观察表明,出现脑转移症状时,94％的脑瘤期病例血和脑脊液hCG比值小于60:1,但瘤栓期病例hCG比值均大于60:1。提示血和脑脊液hCG比值的变化对脑瘤期诊断较有价值,但对瘤栓期的诊断应结合临床表现及其他检查结果确定。同时分析了化疗对hCG比值的影响。

Diagnostic Value of Ratio of Serum hCG level to CSF in Brain Metastasis of Choriocarcinoma

Human chorionic gonadotropin (hCG) levels in serum and cerebrospinal fluid (CSF) was measured in 23 cases with brain metastasis of gestational choriocarcinoma with other 23 cases of choriocarcinoma without brain metastasis as control. The diagnostic value of the ratio of hCG levels of serum/ CSF in cases with brain metastasis was evaluated. In 94% cases (16/17) with brain metastasis at the stage of tumor formation, the ratio of hCG levels of serum/CSF was <60:1, while in 4 cases of the stage of tumor embolism, the ratio was>60:l. The effect of chemotherapy on hCG serum/CSF ratio was also discussed. Based on these data serum/CSF hCG ratio was found useful in diagnosis of brain metastasis at the tumor formation stage, while at the stage of tumor embolism, the ratio was not so helpful and diagnosis of the disease should be based on clinical manifestations and other diagnostic methods. Moreover, a single hCG determination of serum and CSF could not rule out the passibility of brain metastasis.