Free β-Subunit of Human Chorionic Gonadotropin in Serum Is a Diagnostically Sensitive Marker of Seminomatous Testicular Cancer

Lempiäinen, Anna; Stenman, Ulf‐Håkan; Blomqvist, Carl; Hotakainen, Kristina

doi:10.1373/clinchem.2008.108548

Cited by 50 publications

(34 citation statements)

References 15 publications

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“…Very high concentrations of this variant suggest aggressive disease and are strongly associated with a poor prognosis (7 ). Lempiäninen et al have shown that patients with nonseminomatous testicular cancers have hCG␤ concentrations as high as 10 000 -100 000 pmol/L, which correlated with disease-related mortality (8 ).…”

confidence: 99%

Falsely Decreased Human Chorionic Gonadotropin (hCG) Results Due to Increased Concentrations of the Free β Subunit and the β Core Fragment in Quantitative hCG Assays

et al. 2010

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confidence: 99%

Falsely Decreased Human Chorionic Gonadotropin (hCG) Results Due to Increased Concentrations of the Free β Subunit and the β Core Fragment in Quantitative hCG Assays

et al. 2010

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“…Of 51 patients with nonseminomatous cancers, hCG was elevated in 37 patients (73%) and hCGb in 40 patients (78%) preoperatively, and at relapse, 5 of 18 (28%) patients had an isolated increase in hCGb level. 3 Thanks to rapid improvement of imaging methods, the need for markers in monitoring of seminoma patients has decreased. However, the radiation burden of repeated imaging is not negligible.…”

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confidence: 99%

Monitoring of seminoma patients with serum markers

Hotakainen

Lempiäinen

Stenman

2013

Cancer

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The use of tumor marker determinations for monitoring patients with cancer is common, but this practice is not always evidence-based. Guidelines for monitoring of testicular cancer invariably recommend the use of serum marker determinations, but the recommendations are not based on randomized studies. 1 Vesprini et al 2 have evaluated the validity of this practice in a retrospective study based on chart review of serum tumor marker results during surveillance of stage I seminoma. Lactate dehydrogenase (LDH), human chorionic gonadotropin (hCG), and alpha-fetoprotein (AFP) together with clinical and imaging data were registered. Elevated serum markers were found in 11 of 65 (17%) patients at relapse, but in only 1 did the marker elevation precede detection of relapse by imaging or clinical examination. Thus, the authors conclude that routine measurement of serum markers can be discontinued during surveillance of seminoma.In a study on 42 patients with seminoma, we found elevated concentrations of the hCG heterodimer in 17% of the patients preoperatively, but of the free beta-subunit (hCGb) in 52%. It is noteworthy that in 17 cases (40%), hCGb was the only elevated marker. Of 4 patients with seminoma who had a relapse, 2 had an elevated hCGb level; in 1 patient, this was the first sign of relapse. Of 51 patients with nonseminomatous cancers, hCG was elevated in 37 patients (73%) and hCGb in 40 patients (78%) preoperatively, and at relapse, 5 of 18 (28%) patients had an isolated increase in hCGb level. 3 Thanks to rapid improvement of imaging methods, the need for markers in monitoring of seminoma patients has decreased. However, the radiation burden of repeated imaging is not negligible. As Vesprini et al suggest, gathering additional data on the utility of serum marker determinations is certainly recommended. The results from our study suggest that serum markers, and especially hCGb, still may have a role in the monitoring of patients with seminoma. These results need to be confirmed in larger studies. CONFLICT OF INTEREST DISCLOSUREThe work was funded by grants from Finska L€ akares€ allskapet (all authors, one grant each) and a grant from the Finnish Cancer Organizations (Ulf-Håkan Stenman

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“…hCG is markedly elevated with pure choriocarcinoma, and also elevated in embryonal cell carcinoma. In seminoma, hCG is elevated in 10-20% of patients with clinical stage I disease and in up to 30-50% of patients with disseminated disease [3]. The normal value in men is less than 1.5 IU/ml.…”

Section: Human Chorionic Gonadotropinmentioning

confidence: 95%

Serum tumor markers and their utilization in the management of germ-cell tumors in adult males

Salem

Gilligan²

2011

Expert Review of Anticancer Therapy

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Free β-Subunit of Human Chorionic Gonadotropin in Serum Is a Diagnostically Sensitive Marker of Seminomatous Testicular Cancer

Abstract: BACKGROUND:We studied whether measurement of the free ␤ subunit of human chorionic gonadotropin (hCG␤) in serum offers additional diagnostic information compared to determination of intact hCG alone in testicular cancer.

Cited by 50 publications

References 15 publications

Falsely Decreased Human Chorionic Gonadotropin (hCG) Results Due to Increased Concentrations of the Free β Subunit and the β Core Fragment in Quantitative hCG Assays

Falsely Decreased Human Chorionic Gonadotropin (hCG) Results Due to Increased Concentrations of the Free β Subunit and the β Core Fragment in Quantitative hCG Assays

Monitoring of seminoma patients with serum markers

Serum tumor markers and their utilization in the management of germ-cell tumors in adult males

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