Antimüllerian hormone as a serum marker of granulosa cell tumors of the ovary: Comparative study with serum α-inhibin and estradiol,☆☆,,★★

https://doi.org/10.1016/S0002-9378(96)70333-2Get rights and content

Abstract

OBJECTIVE: Our purpose was to evaluate serum antimüllerian hormone as a marker for granulosa cell tumors. STUDY DESIGN: Serum antimüllerian hormone concentrations were determined in 16 patients with an adult-type granulosa cell tumor; in female patients with ovarian adenocarcinoma, benign ovarian cysts, or extraovarian cancers; and in normal premenopausal and postmenopausal women. Serum antimüllerian hormone, α-inhibin, and estradiol levels were compared in 10 patients with a granulosa cell tumor during 6 to 47 months of follow-up. RESULTS: Serum antimüllerian hormone was undetectable in normal postmenopausal women and was <5 μg/L in premenopausal women. Normal serum levels were found in patients with ovarian cancers or cysts or with extraovarian cancers. Levels were between 6.8 and 117.9 μg/L in eight of nine patients with a progressive granulosa cell tumor. In the remaining case antimüllerian hormone, α-inhibin and estradiol concentrations were normal. Serum antimüllerian hormone and α-inhibin levels became elevated at least 11 months before the recurrence was clinically detectable. During clinical remission serum antimüllerian hormone, α-inhibin, and estradiol were normal in most cases. CONCLUSION: Serum antimüllerian hormone is a sensitive, specific, reliable marker of adult-type granulosa cell tumors and is useful to evaluate the efficacy of treatment and to detect recurrences early. (AM J OBSTET GYNECOL 1996;174:958-65.)

Section snippets

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.

. Serum AMH levels in normal women and in women with

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.

References (24)

  • A Kauppila et al.

    GnRH agonist analog therapy in advanced/recurrent granulosa cell tumors: further evidence of a role of inhibin in monitoring response to treatment

    Gynaecol Endocrinol

    (1992)
  • S Ueno et al.

    Cellular localization of müllerian inhibiting substance in the developing rat ovary

    Endocrinology

    (1989)
  • Cited by (157)

    • Atypical Presentation of Granulosa Cell Tumor in an Adolescent: A Case Report

      2023, Journal of Pediatric and Adolescent Gynecology
    • Germ cell, stromal, and other ovarian tumors

      2023, DiSaia and Creasman Clinical Gynecologic Oncology
    • Diagnostic value of Anti-Mullerian hormone in ovarian granulosa cell tumor: A meta-analysis

      2020, European Journal of Obstetrics and Gynecology and Reproductive Biology
    View all citing articles on Scopus

    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

    ☆☆

    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.

    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.

    ★★

    0002-9378/96 $5.00 + 0 6/1/68970

    View full text