Judith L. Vaitukaitis

Glycoprotein-hormone alpha-chain production by pancreatic endocrine tumors: A specific marker for malignancy. Immunocytochemical analysis of tumors of 155 patients

Human chorionic gonadotropin (hCG) or its α‐ and β‐subunits have been proposed as specific quantitative markers for malignant pancreatic endocrine tumors.1 Since proof of malignancy of pancreatic endocrine tumors is difficult early in the course of the illness, we tested retrospectively a series of 157 pancreatic endocrine tumors of 155 patients for α‐ or β‐subunits of hCG by immunocytochemistry. Human CG‐α‐immunoreactive cells were present in 42 of 56 (75%) functioning malignant pancreatic endocrine tumors but in only one, possibly benign, glucagonoma of 67 functioning benign tumors, in only one of 17 nonfunctioning malignant and in none of 17 nonfunctioning benign tumors. No β‐hCG‐immunoreactivity was localized in the tumors. Human CG‐α‐appears to be a reliable quantitative and qualitative marker for malignancy in functioning pancreatic endocrine tumors.

Shortened luteal phase after ovulation induction with human menopausal gonadotropin and human chorionic gonadotropin.

Serum hormonal profiles were characterized in 126 treatment cycles from 24 anovulatory women who underwent ovulation induction therapy with sequential human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG). Of the 98 presumptively ovulatory treatment cycles, 18 had luteal phases lasting 11 days or less. Sixteen of these 18 cycles had one or more of the following features: serum hCG concentrations of less than 75 mIU/ml 24 hours after hCG administration or peak preovulatory estradiol (E2) levels either less than 200 pg/ml or greater than 2000 pg/ml. Midluteal serum progesterone levels were less than 10 ng/ml in seven of the shortened cycles. Only one of these features (E2 greater than 2000 pg/ml) was present in any cycle (n = 2) resulting in pregnancy. Our observations suggest that serum E2 and hCG levels will reflect the apparent adequacy of luteal function during hMG/hCG treatment cycles.

Falsely positive specific human chorionic gonadotropin assays in patients with testicular tumors: Conversion to negative with testosterone administration

We report false elevations of serum human chorionic gonadotropin levels in 4 patients with testicular germ cell tumors. Elevated circulating luteinizing hormone levels that resulted from unilateral orchiectomy were responsible for the falsely positive human chorionic gonadotropin activity measured in commercial radioimmunoassays. In 3 patients tested aliquots of serum evaluated in reliable human chorionic gonadotropin assay systems revealed no elevation. We administered testosterone to 3 patients who had elevations of luteinizing hormone and human chorionic gonadotropin levels. Luteinizing hormone was suppress-d to normal levels 1 week later in 2 patients and in 1 it was diminished but still slightly elevated. In all 3 cases the falsely positive human chorionic gonadotropin results converted to negative. Recognition of falsely positive elevations of human chorionic gonadotropin can spare patients unnecessary operations and/or chemotherapy.

Large‐cell calcifying sertoli cell tumor of the testis. An ultrastructural, immunocytochemical, and biochemical study

This report describes the ultrastructural and hormonal characteristics of the recently described largecell calcifying Sertoli cell tumor of the testis, a rare subtype of pure Sertoli cell tumor. The ultrastructural findings showed similarity to normal Sertoli cells, pure Sertoli cell tumors, Sertoli cells in azoospermic human testes, and the Sertoli cell component of Sertoli‐Leydig cell tumors. Ultrastructure indicated features common to steroid‐producing cells. Testosterone and estradiol were demonstrated in the tumor by immunocytochemical and biochemical methods.

Peptide hormones as tumor markers

Ectopic production and secretion of hormones by a wide variety of tumors were initially recognized by signs and symptoms of excess circulating biologically active hormone. With the development of more sophisticated and sensitive techniques, it has become apparent that not all tumors secrete biologically active hormones. Some altered forms of polypeptide hormones may be in very high concentrations immunologically but be inactive biologically. On the other hand, polypeptide hormones may circulate at concentrations too low to induce clinical signs and symptoms. Consequently, new ectopic humoral syndromes have been recognized and the incidence of previously described syndromes has become considerably greater than previously recognized. Every hormone known to be normally secreted by endocrine organs or the placenta has been documented to be secreted ectopically by a wide variety of tumors. Moreover, several of those hormones may be used as biochemical markers of malignancy for both screening and monitoring of patients with documented or suspected tumors.

Glycoprotein Hormones and Their Subunits—Immunological and Biological Characterization

With the advent of more sophisticated purification and isolation techniques for the glycoprotein hormones and their subunits, reagents have been generated to foster a better understanding of the immunological and physiological control of glycoprotein hormone synthesis and secretion. The human glycoproteins—luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), and human chorionic gonadotropin (hCG)—are all composed of a protein core with branched carbohydrate side chains usually terminating with sialylic acid.

Plasma hormones and the sexual preferences of men

Abstract (1) 190 men undergoing treatment in venereal disease clinics were screened for sexual activity and preference. Based on answers given to a questionnaire, subjects were assigned to one of five groups, ranging from exclusively heterosexual to exclusively homosexual. (2) Endocrine profiling of subjects was performed by measuring a random serum sample for basal LH, FSH, prolactin and testosterone. (3) The mean values for each hormone were not significantly different for any of the groups. (4) This offers further evidence that homosexual males have normal basal levels of testosterone, prolactin, FSH and LH.

Hormone-Secreting Tumors

Tumors may produce many classes of substances including hormones, enzymes, and biogenic amines. These substances are usually indistinguishable from their native counterparts and are normally synthesized and secreted in response to physiological stimuli. This discussion will focus on hormone-secreting tumors and their clinical presentations. For practical purposes, every hormone known to be physiologically secreted has been associated with ectopic tumor secretion. Peptide hormones are the most frequently produced ectopic hormones. Ectopic secretion of corticosteroids and thyroid hormones are extremely rare, probably because they require more sophisticated, compartmentalized enzymatic synthesis.

Ovarian refractoriness not related to the "down receptor phenomenon".

The present studies were undertaken to explore possible mechanisms responsible for the relatively rapid onset of ovarian refractoriness to repeated hormonal stimulation in view of the fact that the “down receptor phenomenon” requires several hours to become manifest. Pseudopregnant rats were given intravenous injections of 0.1 ug (1.12 IU) hCG separated by intervals ranging from one to 96 hours. Some animals were pretreated with cycloheximide and other groups of animals were initially injected with 0.1 ug followed by a second ten-fold higher dose of hCG one hour later when the refractory state was known to be present.No hCG-induced cyclic AMP and CDPK responses were observed after a second 0.1 ug hCG injection separated by one hour up to 72 hours after the initial 0.1 ug hCG injection. The refractory state was not absolute since a ten-fold higher dose of hCG given one hour after the first did elicit a significant increase in intraovarian cyclic AMP concentrations as well as a significant change in CDPK ho...

Clinical Usefulness of Markers in Monitoring Patients with Cancer

In recent years there has been increasing interest in the identification and clinical application of tumor-associated antigens. Most antigens associated with tumors may be subclassified simply as hormonal or non-hormonal. Some of those markers may be found associated with some tumors as well as normal fetal fluids or tissues and, consequently, are termed oncofetal proteins. Those fetal antigens may be present in some tissues and serum of the fetus in large quantities, but circulate at considerably lower concentrations at the end of gestation and in the adult. Oncofetal proteins include alphafetoprotein and carcinoembryonic antigen. Some hormonal markers provide clues to occult carcinomas because of associated paraendocrine syndromes. In most cases, tumor production of hormonal or non-hormonal substances does not result in clinical syndromes. In selected cases, hormonal and non-hormonal markers may provide excellent markers to monitor tumor therapy and recurrence. The “ideal” tumor marker has never been realized in that a substance has not been identified for a specific tumor type and not found in sera of patients without tumor.