MEASUREMENT OF URINARY BETA-CORE FRAGMENT OF HUMAN CHORIONIC-GONADOTROPIN IN WOMEN WITH VULVO-VAGINAL MALIGNANCY AND ITS PROGNOSTIC-SIGNIFICANCE

Tumours of the vulva and vagina are rare and there are relatively few studies of circulating markers in these conditions. The urinary measur ement of the core fragment of the beta-subunit of hCG has been propose d as a useful tumour marker in non-trophoblastic gynaecological malign ancies. This study describes the measurement of urinary beta-core in 5 0 patients with vulvovaginal malignancy. In contrast to other studies, corrections were made for both the effect of urine concentration and the age of the patient. Each patient was followed up for at least 24 m onths, and at this time their status was correlated with their initial level of urinary beta-core. The sensitivity of beta-core was only 38% , but of those patients with elevated levels 90% had died within 24 mo nths, while only 32% of those with normal levels had died. For both pa tients at initial presentation and those with recurrent disease, there was a highly significant difference in the survival curves between th ose with elevated beta-core levels and those with normal levels. This is similar to findings in cervical carcinoma, and suggests that for lo wer genital tract cancer the measurement of urinary beta-core may be v aluable as a prognostic indicator, allowing a more informed approach t o treatment and follow-up.