Background: An influence of gonadotropins (hCG) on the development of ovarian cancer has been discussed.\r\nTherefore, we quantified serum hCG levels in patients with benign and malignant ovarian tumors and the hCG\r\nexpression in ovarian cancer tissue in order to analyze its relation to grade, stage, gonadotropin receptor (LH-R,\r\nFSH-R) expression and survival in ovarian cancer patients.\r\nMethods: Patients diagnosed and treated for ovarian tumors from 1990 to 2002 were included. Patient\r\ncharacteristics, histology including histological subtype, tumor stage, grading and follow-up data were available.\r\nSerum hCG concentration measurement was performed with ELISA technology, hCG tissue expression determined\r\nby immunohistochemistry.\r\nResults: HCG-positive sera were found in 26.7% of patients with benign and 67% of patients with malignant ovarian\r\ntumors. In addition, significantly higher hCG serum concentrations were observed in patients with malignant compared\r\nto benign ovarian tumors (p = 0.000). Ovarian cancer tissue was positive for hCG expression in 68%. We identified\r\nsignificant differences in hCG tissue expression related to tumor grade (p = 0.022) but no differences with regard to the\r\nhistological subtype. In addition, mucinous ovarian carcinomas showed a significantly increased hCG expression at FIGO\r\nstage III compared to stage I (p = 0.018). We also found a positive correlation of hCG expression to LH-R expression, but\r\nnot to FSH-R expression. There was no significant correlation between tissue hCG expression and overall ovarian cancer\r\npatient survival, but subgroup analysis revealed an increased 5-year survival in LH-R positive/FSH-R negative and hCG\r\npositive tumors (hCG positive 75.0% vs. hCG negative 50.5%).\r\nConclusions: Serum human gonadotropin levels differ in patients with benign and malignant ovarian tumors. HCG\r\nis often expressed in ovarian cancer tissue with a certain variable relation to grade and stage. HCG expression\r\ncorrelates with LH-R expression in ovarian cancer tissue, which has previously been shown to be of prognostic\r\nvalue. Both, the hormone and its receptor, may therefore serve as targets for new cancer therapies.
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