Prospective evaluation of two tumor-associated proteins in pancreatic adenocarcinoma

Twenty-eight patients with biopsy-proven, surgically staged pancreatic adenocarcinoma were prospectively studied for elevations in plasma carcinoembryonic antigen (CEA) and serum α and β subunits of human chorionic gonadotropin (hCG). At the time of presentation, the CEA was elevated in 57% of patients, the hCG-β in 7.3%, and the hCG-α in no one. Twenty-five patients were placed on a treatment protocol and followed regularly until disease progression. With respect to CEA, 3 patients with initially elevated value showed at least a twofold increase in level prior to or concurrent with disease progression, and 5 patients never had an abnormal value. Finally, while hCG-α remained normal in all patients throughout their treatment course, hCG-β became elevated in 3 patients having been normal at the time of presentation. Thus, a total of 17.5% of patients had an elevated hCG-β sometime during their clinical course. While the combined assays did not improve diagnostic sensitivity, an hCG-β elevation developed 13 weeks prior to a CEA elevation and 17 weeks prior to documented disease progression in one patient. Due to the difficulty in documenting disease progression clinically in this disease, the hCG-β may be a useful tool to monitor disease activity. Moreover, the reported elevation of hCG-α in pancreatic islet cell tumors supports the difference in their cell of origin from hCG-β producing solid adenocarcinomas and suggests separate genetic control governing the production of certain placental polypeptides. Cancer 43:591–595, 1979.