PROLACTIN - ITS ROLE IN ADVANCED TONGUE CANCER

Serum prolactin was measured pretherapeutically and sequentially there after using immunoradiometric assay method in 37 male patients with ad vanced tongue cancer and compared with 23 healthy, age-matched control s. Prolactin levels were correlated with age, various clinicopathologi c parameters, overall survival, and patients with response and those w ith progressive disease. Patients with advanced tongue cancer had high er prolactin levels than controls (P < 0.02), but intergroup variation in prolactin was not observed when considering the age, site of the l esion, disease stage, histologic grade, and keratin. Of the patients, 30% had hyperprolactinemia (prolactin >15.0 ng/ml). To assess the prog nostic significance of pretherapeutic prolactin level, the patients we re divided according to the cutoff level of prolactin (15.0 ng/ml). Hy perprolactinemic patients had more unfavourable prognosis than patient s with prolactin <15.0 ng/ml (X(2) = 2.91, df = 1, P < 0.0037). In mon itoring disease course, patients who responded to treatments had decre ased prolactin levels at the end of 18 months as compared to their pre therapeutic levels (P < 0.01). In patients who subsequently developed progressive disease within 18 months, prolactin levels reduced initial ly at response, whereas with disease progression, prolactin levels inc reased significantly (P < 0.05). The positive and negative predictive value of prolactin was 100%. Immunohistochemical localization confirme d the ectopic production of prolactin by tongue tumors. In conclusion, our data indicate that hyperprolactinemia may be an independent predi ctor of short-term prognosis; circulating prolactin may be used as a m arker for monitoring disease course in patients with advanced tongue c ancer, and prolactin is produced ectopically by tongue tumors. (C) 199 4 Wiley-Liss, Inc.