Medical Journal of Babylon (Jan 2019)
Expression of beta-human chorionic gonadotropin as a prognostic factor in colorectal carcinoma
Abstract
Background: Colorectal carcinoma (CRC) is a common malignancy in Iraq and carries a high mortality rate. It has been shown that CRCs express high level of beta-human chorionic gonadotropin (β-HCG) as detected by immunohistochemistry. Objectives: The aim of this study was to assess the expression of β-HCG in CRC and to study the association between β-HCG expression and pathological prognostic parameters. Materials and Methods: This study was carried out on 35 colonic specimens consisting of 30 CRC selected from files of Pathologic Laboratory of Al-Kadhymia Teaching Hospital and Teaching Laboratories of the Medical City, Baghdad. Paraffin blocks were cut sections stained with H and E stain and sections for streptavidin-biotin immunohistochemical staining using monoclonal antibody against β-HCG. Immunohistochemical sections were examined for positive or negative staining and positivity assessed as: occasional, focal, and diffuse tumors. Results: Of the 30 CRCs, 60% were male and 40% were female. The most common site of large bowel malignancy was the rectum 13 (43.3%). Most of the tumors were moderately-differentiated adenocarcinoma (83.3%). More than half of the cases were Stage T3, followed by Stage T2, then Stage T4, 3 cases (10%), and no case in Stage T1. Lymph node metastases were found in 19 cases (63.3%). Twelve cases (40%) of CRC show immunoreactivity to β-HCG. β-HCG expression was more frequent in the left side of the large bowel and more common in poorly-differentiated adenocarcinoma (80%). β-HCG was more positive in Stage T4, and there was significant association with lymph node metastasis. Conclusion: Expression of β-HCG in CRC is not an infrequent phenomenon, and no stain was demonstrated in benign and normal colonic specimens, while β-HCG expression associated with poor differentiation, greater local invasion, and regional lymph node metastasis.
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