絨毛性腫瘍患者における血中progesterone, 17α-OH-progesteroneおよびestrogensの分泌動態に関する研究

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Plasma progesterone (P), 17α-OH-progesterone (17P), estrone (E11), 17β-estradiol (E2), estriol (E3) and hCG were measured simultaneously with competitive protein binding assay or radioimmunoassay. Thirty-one patients with trophoblastic diseases including twenty-one hydatidiform moles, two destructive moles, four chorioepitheliomas and four unestablished trophoblastic diseases were studied. Blood samples of these subjects were taken serially before, during and after treatments. The mean concentration of P in cases of unaborted hydatidiform moles was 40.0 ± 13.7 ng/ml (Mean ± S.D.) and those of 17P, E1 and E2 were 4.90 ± 6.08, 0.71 ± 0.92 ng/ml and 2.30 ± 2.55 ng/ml respectively. Plasma 17P in cases of unaborted hydatidiform moles was significantly higher than those of normal pregnancies corresponding to gestation weeks, but the other steroids were not so high in comparison with normal pregnancy. E3 values were not detectable in all patients studied even after the 15th week of gestation. In cases of destructive moles, the mean concentration of P was 31.5 ± 0.71 ng/ml corresponding with 10th week of gestation, and the other steroids were rather low. Most of the patients with chorioepithlioma and unestablished trophoblastic disease showed low steroid levels. Although there was some correlation among each steroid level, there was no correlation between hCG and each steroid in trophoblastic diseases. The levels of plasma steroids fell rapidly preceding the decrease in plasma hCG after the evacuation of hydatidiform moles. In the cases which developed to destructive moles, P, 17P and E2 elevated together with hCG again and then fell rapidly after the hystrectomy. Daily fluctuation of each steroid was not recognized in a chorioepithelioma.
日本内分泌学会の論文

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宮本紀男
京都大学医学部婦人科学産科学教室

絨毛性腫瘍患者における血中progesterone, 17α-OH-progesteroneおよびestrogensの分泌動態に関する研究

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