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目的研究脑实质生殖细胞肿瘤(GCT)患者脑脊液和血清中人绒毛膜促性腺激素(HCG)水平变化,评价其在肿瘤诊断、疗效监测中的意义。方法对5例脑实质内GCT患者的脑脊液和血清HCG水平在治疗前后进行系列测定。以10例性别年龄匹配的因其他疾病接受腰穿检查的患者作为对照组,测定其脑脊液HCG水平。观察脑脊液和血清HCG水平在治疗前后的变化情况。结果10例对照组患者的脑脊液中均测不到HCG。从5例GCT患者共采集17对脑脊液和血清配对样本。所有5例患者都出现脑脊液和血清HCG水平升高。治疗后脑脊液和血清HCG水平迅速下降。血清和脑脊液HCG水平呈显著相关。每一对样本中,脑脊液HCG水平均高于血清。血清、脑脊液HCG水平比为0.245±0.190。结论脑脊液HCG升高对诊断脑实质内GCT具有高度特异性和较高灵敏度。对分泌HCG的GCT,脑脊液和血清HCG是评价治疗效果和监测肿瘤复发的重要指标。
Objective To study the changes of human chorionic gonadotropin (HCG) levels in cerebrospinal fluid (CSF) and serum in patients with brain germ cell tumors (GCT) and to evaluate its significance in the diagnosis and treatment of tumors. Methods Cerebrospinal fluid and serum HCG levels in 5 patients with intracranial GCT were measured before and after treatment. Ten cases of sex-matched age-matched patients with lumbar puncture due to other diseases were selected as the control group, and CSF HCG levels were measured. Changes of CSF and serum HCG levels before and after treatment were observed. Results 10 cases of control group patients were not measured in cerebrospinal fluid HCG. A total of 17 pairs of cerebrospinal fluid and serum paired samples were collected from 5 GCT patients. Cerebrospinal fluid and serum HCG levels increased in all 5 patients. Cerebrospinal fluid and serum HCG levels dropped rapidly after treatment. Serum and cerebrospinal fluid HCG levels were significantly correlated. In each pair of samples, cerebrospinal fluid HCG levels were higher than serum. Serum, cerebrospinal fluid HCG level was 0.245 ± 0.190. Conclusions The elevated HCG in cerebrospinal fluid is highly specific and sensitive for the diagnosis of intracranial GCT. GCG secretion of HCG, cerebrospinal fluid and serum HCG is an important indicator of evaluation of treatment and monitoring of tumor recurrence.