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 CRCsexpress high level of beta‑human chorionic gonadotropin (β‑HCG) as detected by immunohistochemistry. Objectives: The aim of thisstudy was to assess the expression of β‑HCG in CRC and to study the association between β‑HCG expression and pathological prognosticparameters. Materials and Methods: This study was carried out on 35 colonic specimens consisting of 30 CRC selected from files ofPathologic Laboratory of Al‑Kadhymia Teaching Hospital and Teaching Laboratories of the Medical City, Baghdad. Paraffin blocks werecut sections stained with H and E stain and sections for streptavidin‑biotin immunohistochemical staining using monoclonal antibody againstβ‑HCG. Immunohistochemical sections were examined for positive or negative staining and positivity assessed as: occasional, focal, anddiffuse tumors. Results: Of the 30 CRCs, 60% were male and 40% were female. The most common site of large bowel malignancy was therectum 13 (43.3%). Most of the tumors were moderately‑differentiated adenocarcinoma (83.3%). More than half of the cases were StageT3, 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 andmore common in poorly‑differentiated adenocarcinoma (80%). β‑HCG was more positive in Stage T4, and there was significant associationwith lymph node metastasis. Conclusion: Expression of β‑HCG in CRC is not an infrequent phenomenon, and no stain was demonstratedin benign and normal colonic specimens, while β‑HCG expression associated with poor differentiation, greater local invasion, and regionallymph node metastasis.