Serum Müllerian Inhibiting Substance/Anti-Müllerian Hormone levels in patients with adult granulosa cell tumors directly correlate with aggregate tumor mass as determined by pathology or radiology

• Published in: Gynecologic oncology Vol. 114; no. 1; pp. 57 - 60
• Main Authors: Chang, Henry L, Pahlavan, Nima, Halpern, Elkan F, MacLaughlin, David T
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2009
• Subjects: Adult; Adult granulosa cell tumor; Anti-Mullerian Hormone - blood; Anti-Müllerian hormone; Female; Granulosa Cell Tumor - blood; Granulosa Cell Tumor - diagnostic imaging; Granulosa Cell Tumor - pathology; Hematology, Oncology and Palliative Medicine; Humans; Müllerian Inhibiting Substance; Neoplasm Staging; Obstetrics and Gynecology; Ovarian Neoplasms - blood; Ovarian Neoplasms - diagnostic imaging; Ovarian Neoplasms - pathology; Ovarian sex-cord stromal tumor; Prognosis; Radiography; Recurrence; Retrospective Studies; Adult granulosa cell tumor; Müllerian Inhibiting Substance; Anti-Müllerian hormone; Ovarian sex-cord stromal tumor
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2009.02.023

Abstract Objectives Granulosa cell tumors (GCTs) comprise 2–5% of ovarian tumors. Serum Müllerian Inhibiting Substance (MIS, also known as anti-Müllerian hormone, or AMH) levels have been validated as a marker of GCT recurrence and progression. There has been little correlation between serum MIS/AMH levels and several clinical parameters in GCTs, including tumor burden. We have performed a retrospective review correlating aggregate tumor mass as reported by pathologic examination or by radiology with serum MIS/AMH levels drawn on the date of examination. Methods We retrospectively identified 32 GCT patients at our institution over the last 15 years who had serum MIS/AMH measurements. Patients who had serum MIS/AMH measurements within three days of surgery or on the same day as abdominal computerized tomography scan (CT) or magnetic resonance imaging (MRI) were further evaluated. Results We found a significant direct correlation between patient serum MIS/AMH levels and gross aggregate tumor mass determined by pathology (slope = 15.4 ± 6.06, r = 0.65, p < 0.04) or by radiographic aggregate tumor mass for all data points identified (slope = 0.07 ± 0.03, r = 0.33, p < 0.04) and after correcting for selection bias (slope = 1.45 ± 0.17, r = 0.93, p < 0.01). We also identified a significant difference between serum MIS/AMH levels between samples drawn the same day as negative and positive abdominal CT or MRI scans (8.16 ± 1.54 vs. 158.7 ± 32.2 ng/ml, p < 0.0001). Conclusions These data indicate a significant direct correlation between serum MIS/AMH levels and both gross and radiographic aggregate tumor mass in GCT patients. Together with the current literature, the present data argue for a more prominent role for serum MIS/AMH in the management of GCTs.