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Human Chorionic Gonadotropin: Tumor Marker in Testicular Cancer

Human chorionic gonadotropin (HCG) is a glycoprotein hormone, molecular mass 40000 daltons, and consists of 2 interconnected alpha and beta subunits. During pregnancy, HCG is produced by the placenta to preserve the corpus luteum. In germ cell tumors, HCG is produced in chorionic carcinoma or in syncytiotrophoblastic giant cells (seminoma, embryonic carcinoma, yolk sac tumor, dysgerminoma). In choriocarcinoma, the HCG concentration correlates almost linearly with the tumor mass, with 10 mIU/ml corresponding to approximately 1,000,000 tumor cells.

Standard Value of Human Chorionic Gonadotropin

Human chorionic gonadotropin (HCG) should be below 5 mIU/ml in men and in non-pregnant females.

Laboratory Test Method

ELISA.

Indications

Diagnosis and follow-up in germ cell tumors. Diagnosis of pregnancy.

Differential Diagnosis of Increased Human Chorionic Gonadotropin

• In men: testicular cancer.
• In women: pregnancy and ectopic pregnancy. Ovarian cancer.
• Rare HCG-production in malignant tumors of liver, pancreas, stomach, lung, breast and kidney.

Kinetics of HCG after Treatment of Testicular Cancer

After a complete tumor resection, postoperative concentration decline to the normal range with a half-live of 24–36 hours. An incomplete or slow decrease after radical orchiectomy is suspicious for metastasis of germ cell tumor. A rebound of HCG after normalization is a sign of tumor recurrence or metastasis. A rising HCG level is incompatible with healing of testicular cancer and can indicate tumor progression weeks or months before radiological diagnosis.

References

  Deutsche Version: Tumormarker HCG (humanes Choriongonadotropin)