ELEVATED HUMAN CHORIONIC-GONADOTROPIN CONCENTRATIONS IN THE TESTICULAR VEIN AND IN PERIPHERAL VENOUS-BLOOD IN SEMINOMA PATIENTS - AN ANALYSIS OF VARIOUS PARAMETERS

Objective: Human chorionic gonadotropin (HCG) elevations in the testic ular vein (TV) are correlated with those in the cubital vein (CV). The ir significance was tested regarding various prognostic parameters. Me thod: Within the framework of a large multicentre study to assess the prognosis of HCG-positive seminomas 726 eligible patients were recruit ed from 1986 to 1991. A total of 378 had elevated and 348 had normal H CG measured in the CV. In 144 patients samples were taken from the TV. Histological diagnosis of seminoma was confirmed by two reference pat hologists. Three groups (group I: elevated HCG in CV and normal or ele vated HCG in TV; group II: normal HCG in CV and elevated HCG in TV; gr oup III: normal HCG in CV and normal or unknown HCG in TV) were compar ed in relation to the presence or absence of metastases, stage of the disease, size of the primary tumour, pT category, vascular invasion an d lactate dehydrogenase. Results: Of the TV serum samples, 85% were HC G-positive. Regression analysis revealed higher values in the TV compa red to the CV according to the following equation: HCG(TV) = 520 + 1.1 2 x HCG(CV), R = 0.766, with a mean variation of 14%. Patients in grou p I had significantly higher stages and larger primary tumours than pa tients with normal HCG in the CV, irrespective of the HCG values in th e TV blood (groups II and III). Therefore, HCG is associated with tumo ur mass. No differences of statistical significance were found regardi ng T category, vascular invasion and lactate dehydrogenase. There were no differences between groups II and III. Conclusion: Only HCG values of the CV are associated with known adverse-prognostic factors of sem inomas, such as metastases and size of the tumour. HCG in the TV adds no further information for the clinical assessment of patients with se minoma.