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Review |
hCG Reference Laboratory, 308 FMB, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06520. Fax 203-785-6367; e-mail laurence.cole{at}yale.edu
Multiple hCG-related molecules are present in pregnancy serum and urine
samples. These include nonnicked hCG (the hormone), nicked hCG, hyper-
and hypoglycosylated hCG, hCG missing the C-terminal extension, free
-subunit, large free -subunit, free ß-subunit, nicked free
ß-subunit, and ß-core fragment. Over 100 immunoassays are sold for
quantifying hCG-related molecules in serum or urine. Each measures
nonnicked hCG and one of seven combinations of the other hCG-related
molecules. This is the source of interassay discordance in hCG
determinations. Whereas minor variations are noted in different kit
results in normal pregnancy samples (more than twofold variation), much
larger variations may be found in two immunoassay results in irregular
gestations (spontaneous abortion, aneuploidy, preeclampsia, cancers,
and trophoblast disease). Care is needed in choosing an immunoassay.
What the assay measures may be more important than its cost or speed.
This article reviews the structure of hCG and related molecules. It
examines the stability and degradation of hCG, and recognition of
hCG-related molecules by different types of immunoassay. Also reviewed
are new assays for specifically detecting these other hCG-related
molecules.
The following articles in journals at HighWire Press have cited this article:
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  L Ranganath, W Taylor, L John, and Z Alfirevic Biochemical diagnosis of placental infarction/damage: acutely rising alkaline phosphatase Ann Clin Biochem, May 1, 2008; 45(3): 335 - 338. [Abstract] [Full Text] [PDF]
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 Z. Cao and R. Rej Are Laboratories Reporting Serum Quantitative hCG Results Correctly? Clin. Chem., April 1, 2008; 54(4): 761 - 764. [Abstract] [Full Text] [PDF]
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 P. Lohstroh, H. Dong, J. Chen, N. Gee, X. Xu, and B. Lasley Daily Immunoactive and Bioactive Human Chorionic Gonadotropin Profiles in Periimplantation Urine Samples Biol Reprod, July 1, 2006; 75(1): 24 - 33. [Abstract] [Full Text] [PDF]
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J. A. Snyder, S. Haymond, C. A. Parvin, A. M. Gronowski, and D. G. Grenache Diagnostic Considerations in the Measurement of Human Chorionic Gonadotropin in Aging Women Clin. Chem., October 1, 2005; 51(10): 1830 - 1835. [Abstract] [Full Text] [PDF]
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P. von Lode, J. Rainaho, and K. Pettersson Quantitative, Wide-Range, 5-Minute Point-of-Care Immunoassay for Total Human Chorionic Gonadotropin in Whole Blood Clin. Chem., June 1, 2004; 50(6): 1026 - 1035. [Abstract] [Full Text] [PDF]
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L. A. Cole, J. M. Sutton, T. N. Higgins, and G. S. Cembrowski Between-Method Variation in Human Chorionic Gonadotropin Test Results Clin. Chem., May 1, 2004; 50(5): 874 - 882. [Abstract] [Full Text] [PDF]
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P. T.A. Borrelli, S. A. Butler, S. M. Docherty, E. M. Staite, A. L. Borrelli, and R. K. Iles Human Chorionic Gonadotropin Isoforms in the Diagnosis of Ectopic Pregnancy Clin. Chem., December 1, 2003; 49(12): 2045 - 2049. [Abstract] [Full Text] [PDF]
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M. O. Carayannopoulos, D. G. Grenache, and A. M. Gronowski Total {beta}-Human Chorionic Gonadotropin Measured in Urine by an Automated Method Clin. Chem., October 1, 2002; 48(10): 1796 - 1797. [Full Text] [PDF]
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 D. M. Parrish and D. E. Bruns US Legal Principles and Confidentiality of the Peer Review Process JAMA, June 5, 2002; 287(21): 2839 - 2841. [Abstract] [Full Text] [PDF]
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S. A. Butler, S. A. Khanlian, and L. A. Cole Detection of Early Pregnancy Forms of Human Chorionic Gonadotropin by Home Pregnancy Test Devices Clin. Chem., December 1, 2001; 47(12): 2131 - 2136. [Abstract] [Full Text] [PDF]
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 C. B. Hammond False Positive hCG Obstet. Gynecol., November 1, 2001; 98(5): 719 - 720. [Full Text] [PDF]
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T. G. Olsen, P. R. Hubert, and L. R. Nycum Falsely Elevated Human Chorionic Gonadotropin Leading to Unnecessary Therapy Obstet. Gynecol., November 1, 2001; 98(5): 843 - 845. [Abstract] [Full Text] [PDF]
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Y. C. Casart, M. I. Camejo, F. Proverbio, and F. Febres Bioactivity of Serum hCG in Preeclampsia Obstet. Gynecol., September 1, 2001; 98(3): 463 - 465. [Abstract] [Full Text] [PDF]
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L. A. Cole, S. Shahabi, S. A. Butler, H. Mitchell, E. S. Newlands, H. R. Behrman, and H. L. Verrill Utility of Commonly Used Commercial Human Chorionic Gonadotropin Immunoassays in the Diagnosis and Management of Trophoblastic Diseases Clin. Chem., February 1, 2001; 47(2): 308 - 315. [Abstract] [Full Text] [PDF]
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 H. J. de Haard, N. van Neer, A. Reurs, S. E. Hufton, R. C. Roovers, P. Henderikx, A. P. de Bruine, J.-W. Arends, and H. R. Hoogenboom A Large Non-immunized Human Fab Fragment Phage Library That Permits Rapid Isolation and Kinetic Analysis of High Affinity Antibodies J. Biol. Chem., June 25, 1999; 274(26): 18218 - 18230. [Abstract] [Full Text] [PDF]
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L. A. Cole, K. M. Rinne, S. Shahabi, and A. Omrani False-Positive hCG Assay Results Leading to Unnecessary Surgery and Chemotherapy and Needless Occurrences of Diabetes and Coma Clin. Chem., February 1, 1999; 45(2): 313 - 314. [Full Text] [PDF]
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G. Kovalevskaya, S. Birken, T. Kakuma, J. Schlatterer, and J. F. O'Connor Evaluation of Nicked Human Chorionic Gonadotropin Content in Clinical Specimens by a Specific Immunometric Assay Clin. Chem., January 1, 1999; 45(1): 68 - 77. [Abstract] [Full Text] [PDF]
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L. A. Cole, T. J. Abbott, and E. G. Armstrong Comment on the Nature and Specificity of Bayer Corporation and Chiron Diagnostics hCG Immunoassays Clin. Chem., September 1, 1998; 44(9): 2001 - 2002. [Full Text] [PDF]
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