Human Trophoblast Neoplasms (Advances in Experimental Medicine and Biology, 157)

This book addresses neoplasms of the human trophoblast. The scant literature available on the epidemiology of trophoblast neoplasms suggests that they are as much as ten times more common in Africa, Asia, India, and much of the developing world than in Western countries. The stimulus for the book evolved out of a common interest to combine Western technology with the clinical experience in the developing world in a common pursuit of the study and eradication of trophoblast neoplasia. There is substantial evidence to contend that gene derepression as seen in trophoblastic disease may be a universal prerequisite to neoplastic transformation in general. The recent discovery that the tumor markers, human chorionic gonadotropin (hCG) or its subunits, are identifiable in over 90 percent of all extracted neoplasms suggests a critical role for this common denominator of gene derepression in neoplasia. This gene derepression concept in reproductive biology and neoplasia spans many of the basic parameters of human cell replication as related to endocrinology, immunology, biochemistry, electrophysiol­ ogy, genetics, and pharmacology. The International Society for the Study of Trophoblastic Disease focuses on the global aspects of trophoblast neoplasms. These global aspects include epidemiology and etiology of the disease, regional variations in treatment of trophoblastic neoplasms, and potential ways to adapt and apply Western technology to effective use in developing countries. It was this perspective that formed the basis for the First World Congress on Trophoblast Neoplasms, which convened in Nairobi in October, 1982. Front Matter....Pages i-x Front Matter....Pages 1-2 On the Nature of Gestational Trophoblastic Disease....Pages 3-12 Exposure to Chemical Carcinogens During Pregnancy: Consequences for Mother and Conceptus....Pages 13-49 Front Matter....Pages 51-52 Genetic Origin, Immunobiology, and Gonadotropin Expression in Trophoblast and Nontrophoblast Neoplasms....Pages 53-79 Immunology in Genesis of Partial and Total Hydatidiform Mole....Pages 81-110 Complement System in Abnormal Pregnancy and Chorionic Neoplasia: Immunotherapy and Chemotherapy of Chorionic Neoplasia....Pages 111-125 Placental Senescence....Pages 127-132 Front Matter....Pages 133-133 Complete and Partial Hydatidiform Moles: Cytogenetic and Morphological Aspects....Pages 135-146 Genetic Studies on Hydatidiform Moles....Pages 147-161 Front Matter....Pages 163-163 Epidemiology of Gestational Trophoblastic Neoplasm at the Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia....Pages 165-175 Epidemiologic Aspects of Gestational Trophoblastic Diseases in Ibadan, Nigeria....Pages 177-185 Epidemiology of Trophoblast Disease in Africa — Lagos....Pages 187-195 Front Matter....Pages 197-197 Immunochemistry of Human Chorionic Gonadotropin....Pages 199-215 New Horizons in hCG Detection....Pages 217-243 The Carbohydrate on Human Chorionic Gonadotropin Produced by Cancer Cells....Pages 245-270 Paradoxical Effect of Antibodies Against Chorionic Gonadotropin on BeWo Choriocarcinoma Cells in Vitro and in Vivo: Evidence for Heterogeneity of Cell Types....Pages 271-287 The Surface Charge of Cells Producing hCG....Pages 289-298 The Role of Trophoblast Differentiation in the Control of the hCG and hPL Genes....Pages 299-312 Clinical Applications of hCG....Pages 313-324 Front Matter....Pages 325-325 A Proposal on the Clinical Staging of Malignant Trophoblastic Neoplasms Based on the Study of Process of Development of the Disease....Pages 327-340 Front Matter....Pages 341-341 The Role of Methotrexate in the Chemotherapy of Gestational Trophoblastic Neoplasms....Pages 343-354 Front Matter....Pages 341-341 Re-Evaluation of 5-Fluorouracil as a Single Agent for Gestational Malignant Trophoblastic Neoplasms....Pages 355-367 Management of Patients with Gestational Trophoblastic Neoplasia: Experience of the Southeastern Regional Center....Pages 369-381 The Role of Regional Centers for Gestational Trophoblastic Disease....Pages 383-400 The Study and Treatment of Gestational Trophoblastic Diseases at the Brewer Trophoblastic Disease Center, 1962 – 1979....Pages 401-408 Pitfalls in the Management of Trophoblastic Disease in Africa....Pages 409-416 The Problems of Management of Gestational Trophoblastic Neoplasms at the University of Benin Teaching Hospital, Benin City, Nigeria....Pages 417-428 Ten Years’ Experience with Trophoblastic Tumors in Portugal....Pages 429-434 First World Congress on Trophoblast Neoplasms....Pages 435-464 Back Matter....Pages 465-505