To determine if immunoreactive
inhibin assayed in serum from women with
granulosa cell tumors correlated with
tumor burden, reflected response to treatment, or predicted recurrent disease.
STUDY DESIGN: Serum samples were collected following bilateral
oophorectomy (BSO) with or without other indicated surgery in 15 patients with
granulosa cell tumors.
Inhibin radioimmunoassay (RIA-Inh) was performed on all samples and results were correlated with
tumor burden, disease status, and treatment response.
RESULTS: Fifteen patients had serum assayed for
inhibin with levels ranging from 0 to 7470 U/liter. In 4 patients with measurable recurrent disease,
inhibin levels correlated directly with
tumor burden (r2 = 0.96). Four patients had serum drawn during clinical remission and in all 4 patients elevated
inhibin levels predated recurrence by a median interval of 11.5 months (range 7-20). The remaining 7 were treated for primary disease and were in clinical remission with a median follow-up of 33 months (range 9-53). Four of these 7 patients were surgically staged: 2 were FIGO Stage I and
inhibin levels fell to 0 U/liter; 2 patients had metastatic disease (Stage IIc and IIIa) and their
inhibin levels were found to be elevated following complete resection. The remaining 3 were not surgically staged, and all had elevated
inhibin levels while in clinical remission, suggesting occult disease. Of the 15 total patients, 1 who was treated with
chemotherapy for recurrent disease was followed with serial
inhibin levels. She showed a complete response to
therapy with
inhibin levels falling from 975 to 0 U/liter with 15 months follow-up.
CONCLUSIONS: