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From the Department of Clinical Chemistry;
* Helsinki University Central Hospital and Helsinki University, Helsinki, Finland; the Department of Surgical and Perioperative Sciences, Urology and Andrology,
Umeå University, Umeå, Sweden; and the Department of Surgery,
Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
Expression of the free ß-subunit of human chorionic gonadotropin (hCGß) in malignant tumors is frequently associated with aggressive disease. The pretreatment serum concentration of hCGß is an independent prognostic variable in renal cell carcinoma (RCC). The three so-called type II genes (hCGß 3/9, 5, and 8) have been shown to be up-regulated in relation to type I genes (hCGß 6/7) in some malignant tumors. We developed a reverse transcription-polymerase chain reaction method for quantification of relative levels of the mRNAs for the two types of hCGß genes and studied the association between the expression in RCC tissue (n = 104) and clinical outcome. hCGß mRNA expression was detected in 40% (42 of 104) of the tumors, and in 40 of these (93%), this consisted of hCGß type I mRNA only, whereas type II hCGß mRNA was detected in two samples. hCGß mRNA expression was significantly associated with a shorter disease-specific (log-rank P = 0.023; median survival 1.4 versus 7.9 years) and overall survival (log-rank P = 0.011). In a Cox regression model, stage (P < 0.0001) and hCGß mRNA expression (P < 0.0001) were independent prognostic variables. We conclude that expression of type I hCGß genes indicates adverse prognosis in RCC.
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