THE PROGNOSTIC-SIGNIFICANCE OF URINARY BETA-CORE FRAGMENT IN PREMENOPAUSAL WOMEN WITH CARCINOMA OF THE CERVIX

The mortality of premenopausal women with cervical carcinoma has incre ased in recent decades despite attempts to provide screening. The urin ary concentration of the beta core fragment of hCG has been proposed a s a sensitive marker in gynecological malignancies, although most stud ies have not corrected for urine concentration, We measured the urinar y concentration of beta core and creatinine in 61 women who developed cervical cancer premenopausally and expressed the concentration of bet a core per millimole of creatinine using the 90th percentile of a cont rol group as a cutoff level. While correcting for urinary concentratio n results in a reduction in sensitivity of the test (67 to 51%), there is improved correlation with prognosis in that after 18 months 81% of women positive for beta core had died, while 80% of women negative fo r beta core were still alive. Of those initially presenting and dying there was an increase with increasing stage of disease. For patients w ith initial presentation disease, 11 (79%) of the 14 patients with ele vated levels had died compared with 1 of 21 (5%) who were negative for beta core. Urinary beta core fragment may have a major role as a prog nostic indicator in cervical carcinoma rather than as a screening or d iagnostic marker and enables identification of patients at higher risk of an aggressive disease. (C) 1994 Academic Press, Inc.