Antimüllerian hormone as a serum marker of granulosa cell tumors of the ovary: Comparative study with serum α-inhibin and estradiol☆,☆☆,★,★★
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Subjects
Serum samples from female patients with a diagnosis of adult-type granulosa cell tumor (n = 16), ovarian Sertoli-Leydig tumor (n = 1), ovarian benign cysts (n = 7), ovarian serous or mucinous adenocarcinoma (n = 20), and extraovarian cancers (n = 48) were obtained from the serum bank of the Institut Gustave Roussy, Villejuif, France (Table I). Diagnoses were confirmed by evaluation of histologic slides. Serum samples of nine of the patients with a diagnosis of granulosa cell tumor were obtained
AMH in normal women
The AMH concentration was below the sensitivity of our immunoassay (<2 μg/L) in all 31 postmenopausal and in 19 of 27 (70.4%) normal premenopausal women. In the other 8 premenopausal controls (29.6%) the serum AMH concentration was (mean ± SD) 2.76 ± 0.80 μg/L, with a highest value of 4.54 μg/L (Fig. 1). We have considered that normal serum AMH levels are <5 μg/L before menopause and undetectable in ovariectomized or postmenopausal women.
COMMENT
AMH is produced in both sexes exclusively in the gonads by the somatic cells deriving from the sex cord stroma (i.e., Sertoli cells of the testis and granulosa cells of the ovary). Elevated serum AMH levels have been reported in four patients with sex cord stromal tumors of the ovary, including three granulosa cell tumors.14 To further evaluate the specificity and sensitivity of serum AMH as a marker of granulosa cell tumors, we studied AMH levels in the serum of 16 patients with a diagnosis of
Acknowledgements
We thank Dr. Richard Cate (Biogen Inc., Cambridge, Mass.) for providing us with the monoclonal antibody 10.6 used in AMH assay, Dr. Gabriel Bialy (National Institutes of Health, Bethesda, Md.) for the supply of human recombinant inhibin, and Drs. David de Kretser and David Robertson (Monash University, Melbourne, Australia) for the supply of reagents for inhibin radioimmunoassay.
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From the Unité de Recherches sur l'Endocrinologie du Développement (Institut National de la Santé et de la Recherche Médicale), Département de Biologie, Ecole Normale Supérieure,a the Service d'Immunologie Moléculaire, Département de Biologie Clinique,b the Service de Gynécologie,c and the Service d'Anatomie Pathologique B,d Institut Gustave Roussy, and the Laboratoire de Biologie Hormonale (Institut National de la Santé et de la Recherche Médicale), Hôpital Saint Vincent de Paul.e
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Supported in part by Contrat de Recherche Clinique grant No. 95.4, Institut Gustave Roussy, Villejuif, France, and by the Association pour la Recherche sur le Cancer, France.
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Reprint requests: Rodolfo Rey, MD, PhD, Institut National de la Santé et de la Recherche Médicale U.293, 1 Rue Maurice Arnoux, 92120 Montrouge, France.
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0002-9378/96 $5.00 + 0 6/1/68970