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Open Access Highly Accessed Research article

Human chorionic gonadotropin and its relation to grade, stage and patient survival in ovarian cancer

Miriam Lenhard1*, Alexandra Tsvilina2, Lan Schumacher2, Markus Kupka2, Nina Ditsch1, Doris Mayr3, Klaus Friese12 and Udo Jeschke2

Author affiliations

1 Department of Obstetrics and Gynecology, Grosshadern Campus, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich, Germany

2 Department of Obstetrics and Gynecology, Campus Innenstadt, Ludwig-Maximilians-University Hospital, Maistrasse 11, 80337 Munich, Germany

3 Department of Pathology, Ludwig-Maximilians-University Hospital, Thalkirchner Str. 36, 80337 Munich, Germany

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Citation and License

BMC Cancer 2012, 12:2  doi:10.1186/1471-2407-12-2

Published: 3 January 2012

Abstract

Background

An influence of gonadotropins (hCG) on the development of ovarian cancer has been discussed. Therefore, we quantified serum hCG levels in patients with benign and malignant ovarian tumors and the hCG expression in ovarian cancer tissue in order to analyze its relation to grade, stage, gonadotropin receptor (LH-R, FSH-R) expression and survival in ovarian cancer patients.

Methods

Patients diagnosed and treated for ovarian tumors from 1990 to 2002 were included. Patient characteristics, histology including histological subtype, tumor stage, grading and follow-up data were available. Serum hCG concentration measurement was performed with ELISA technology, hCG tissue expression determined by immunohistochemistry.

Results

HCG-positive sera were found in 26.7% of patients with benign and 67% of patients with malignant ovarian tumors. In addition, significantly higher hCG serum concentrations were observed in patients with malignant compared to benign ovarian tumors (p = 0.000). Ovarian cancer tissue was positive for hCG expression in 68%. We identified significant differences in hCG tissue expression related to tumor grade (p = 0.022) but no differences with regard to the histological subtype. In addition, mucinous ovarian carcinomas showed a significantly increased hCG expression at FIGO stage III compared to stage I (p = 0.018). We also found a positive correlation of hCG expression to LH-R expression, but not to FSH-R expression. There was no significant correlation between tissue hCG expression and overall ovarian cancer patient survival, but subgroup analysis revealed an increased 5-year survival in LH-R positive/FSH-R negative and hCG positive tumors (hCG positive 75.0% vs. hCG negative 50.5%).

Conclusions

Serum human gonadotropin levels differ in patients with benign and malignant ovarian tumors. HCG is often expressed in ovarian cancer tissue with a certain variable relation to grade and stage. HCG expression correlates with LH-R expression in ovarian cancer tissue, which has previously been shown to be of prognostic value. Both, the hormone and its receptor, may therefore serve as targets for new cancer therapies.

Keywords:
hCG; LH receptor; Ovarian cancer; Prognosis