SERUM PROGESTERONE AND SERUM CHORIONIC GONADOTROPHIN IN HYDATIDIFORM MOLE AND CHORIOCARCINOMA

Abstract

ABSTRACT Progesterone and human chorionic gonadotrophin (HCG) were measured in the sera of 25 patients with hydatidiform mole, 10 patients with choriocarcinoma and 200 normal pregnancies by a competitive protein-binding assay and a haemagglutination-inhibition assay respectively. Elution of the petroleum ether extract of mole serum on Sephadex LH-20 showed that the main fraction (92.8%) was progesterone, followed by a small peak of 20 α-hydroxyprogesterone. In 21 intact hydatidiform moles, the mean serum progesterone of 106.0 ng/ml (range 17.8–263 ng/ml) was higher than for normal pregnancy. Serum HCG (mean 833 IU/ml) was similarly elevated. Low concentrations of progesterone (0–17.3 ng/ml) and HCG (15–160 IU/ml) were present in 4 patients who had aborted. The mean serum progesterone was not further elevated in patients with theca lutein cysts of the ovary. There was no correlation between the serum progesterone and the uterine size, serum HCG or malignant sequelae. In 10 cases of choriocarcinoma, the serum progesterone ranged from 1.3–61 ng/ml (mean 16.9 ng/ml), the serum HCG from 0–960 IU/ml (mean 158 IU/ml) but there was no correlation between the two values. The evidence suggests a hyperactive steroidogenesis in hydatidiform mole and poor steroidogenesis in choriocarcinoma. An HCG secretion occurs in both cases.