MAJOR BASIC-PROTEIN AS A MARKER OF MALIGNANT POTENTIAL IN TROPHOBLASTIC NEOPLASIA

OBJECTIVE: We tested whether serum pregnancy-associated major basic pr otein levels distinguish between benign and malignant trophoblastic di sease. STUDY DESIGN: We compared serum pregnancy-associated major basi c protein levels in seven patient groups: nonpregnant and pregnant con trols, partial moles, complete moles, persistent moles, placental-sits trophoblastic tumors, and choriocarcinoma. RESULTS: The results showe d that patients with partial and complete moles had elevated serum pre gnancy-associated major basic protein levels comparable to normal preg nancy. In contrast, patients with persistent mole, placental-site trop hoblastic tumors and choriocarcinoma had low median serum levels compa rable to those of the nonpregnant controls. Significant differences we re shown between the complete and persistent mole groups (p = 0.0001) and between the complete mole group and the choriocarcinoma group (p = 0.0001); however, persistent moles were indistinguishable from chorio carcinoma (p = 0.2010). CONCLUSION: Serum pregnancy-associated major b asic protein levels thus distinguish between benign disorders, such as pregnancy and partial and complete moles, and trophoblastic tumors, s uch as persistent moles and choriocarcinoma. The absence of elevated s erum levels of pregnancy-associated major basic protein may be useful clinically to indicate a more aggressive or frankly malignant tumor.