Background. The presence of urinary excretion products of human chorionic gonadotropin (hCG) has been proposed as a tumor marker. To ascertain the clinical value in gynecologic cancers, the authors studied 612 nonpregnant women.
Methods. Three different assays in four clinical groups were compared: no disease, benign disease, malignant disease, and complete remission of previously treated malignant disease. The assays were for the urinary β‐core, “total” β‐hCG, and free α‐subunit.
Results. Measurement of the α‐subunit was of no obvious clinical value. In some patients with benign disease, hCG metabolites were elevated. In the 141 patients with active gynecologic malignancy the sensitivity of the total β‐hCG assay was 47% and that of the β‐core assay was 36%. The specificities were 80.3% and 90.4%, respectively. Advanced cancers generally had higher levels of total β‐hCG and β‐core. Squamous cell and poorly differentiated cervical tumors had higher levels of total β‐hCG than did adenocarcinomas and well‐differentiated cervical tumors. Invasive, serous, endometrioid, and germ cell ovarian tumors had higher total β‐hCG, β‐core, and α‐subunit levels than did borderline, mucinous, and clear cell ovarian tumors. Six of 16 patients with disease in complete remission had elevated levels.
Conclusion. The excretion of hCG and its metabolic fragments is a common event in gynecologic cancer, but sensitivity and specificity are low, and there is little consistent relationship between tumor stage and histologic type.