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Clinical Chemistry 54: 1840-1843, 2008. First published September 11, 2008; 10.1373/clinchem.2008.108548
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(Clinical Chemistry. 2008;54:1840-1843.)
© 2008 American Association for Clinical Chemistry, Inc.

Cancer Diagnostics

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

Anna Lempiäinen1,a, Ulf-Håkan Stenman1, Carl Blomqvist2 and Kristina Hotakainen1

Departments of1 Clinical Chemistry and 2 Oncology Helsinki University Central Hospital and Helsinki University, Helsinki, Finland.

aAddress correspondence to this author at: Helsinki University Central Hospital/Biomedicum Helsinki, Room A419a, Haartmaninkatu 8, PO Box 700, FIN-00029. Fax +358-9-47171731; e-mail anna.lempiainen{at}helsinki.fi

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

Methods: We determined hCG and hCGβ with ultrasensitive assays in 94 serum samples obtained preoperatively, 22 samples obtained during relapse, and 3687 samples obtained during routine follow-up of 351 patients with testicular tumors.

Results: In preoperative samples, isolated increases of hCGβ were seen in 40% of the samples from seminoma patients (n = 42) and in 8% of those from patients with nonseminomatous testicular cancer (NSGCT) (n = 51). Both markers were increased in 12% of the seminoma and 71% of the NSGCT patients and were within reference intervals in 43% of the seminoma and 20% of the NSGCT patients. Specific determination of hCGβ increased the frequency of marker-positive seminomas from 17% to 57% and of marker-positive relapses from 32% to 59% (n = 22). Theoretically, about 40% of marker-positive seminomas and relapses would have been missed with an assay measuring hCG and hCGβ together. Preoperative hCG and hCGβ concentrations correlated with stage, tumor histology, and disease-related mortality. Additionally, hCGβ correlated with tumor size.

Conclusions: hCGβ is a diagnostically sensitive marker for testicular cancer. In patients with seminomatous testicular cancer, hCGβ is superior to hCG, and in some NSGCT patients it provides additional information.






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Copyright © 2008 by the American Association for Clinical Chemistry.