Importance of the detection method for intact dimeric human chorionic gonadotropin without interference with the free human chorionic gonadotropin β subunit for pregnancy exclusion before liver transplantation in a woman with cholangiocarcinoma

2005 ◽  
Vol 43 (8) ◽  
Author(s):  
Catherine Massart ◽  
Catherine Lucas ◽  
Nathalie Rioux-Leclercq ◽  
Patricia Fergelot ◽  
Véronique Pouvreau-Quillien ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Detection Method ◽  
Gastrointestinal Cancers ◽  
Cell Secretion ◽  
Specific Serum ◽  
Trophoblastic Tumors ◽  
Β Hcg

AbstractAssay of human chorionic gonadotropin (hCG) is mainly used for the detection and monitoring of pregnancy, and for the follow-up of trophoblastic tumors. The serum free β-hCG subunit (hCGβ) is also a tumor marker in many non-trophoblastic tumors, including gastrointestinal cancers. In this work, we compared the performance of several immunoassays for pregnancy exclusion before liver transplantation and in the follow-up of a woman with cholangiocarcinoma. Serum hCG was detected with the Abbott Testpack plus hCG-Combo and measured with four automated sandwich immunoassays: ADVIA-Centaur, ACS:180, AxSYM and Dimension. hCGβ was determined by an automated fluorescence sandwich immunoassay (Kryptor-Free β hCG) and with a specific immunoradiometric assay (ELSA-F β hCG, Schering). The expression of hCG was also evaluated by immunohistochemistry on sections of intrahepatic cholangiocarcinoma cells and on peritoneal metastases. Before transplantation, discordant results were observed for pregnancy exclusion. Qualitative Testpack and Dimension tests detected no hCG-like immunoreactivity, whereas the ADVIA-Centaur, ACS:180 and AxSYM tests revealed positive levels. The same discrepancy was obtained in follow-up of the patient after liver transplantation. hCGβ assay and immunohistochemical staining revealed tumor cell secretion of hCGβ. In conclusion, a specific serum immunoassay for intact dimeric hCG without cross-reaction with hCGβ should be adopted as routine policy for pregnancy exclusion before liver transplantation.

Analysis of 309 Cases after Hydatidiform Mole: Different Follow-Up Program According to Biologic Behavior

1988 ◽  
Vol 74 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Giorgio Bolis ◽  
Carlo Belloni ◽  
Cristina Bonazzi ◽  
Giorgia Mangili ◽  
Mauro Presti ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Selection Criteria ◽  
Hydatidiform Mole ◽  
Spontaneous Remission ◽  
Obstetrics And Gynecology ◽  
Surveillance Program ◽  
Beta Human Chorionic Gonadotropin ◽  
Trophoblastic Tumors

Between 1976 and 1985, at the Obstetrics and Gynecology Department of Milan University, a total of 309 cases of hydatidiform mole, 223 complete moles and 86 partial moles, were monitored with the assay of beta-human chorionic gonadotropin, following a postmolar biochemical surveillance program. Spontaneous remission of the disease occurred in 287 (92.9%) patients. Marker levels were undetectable in 80.4 % of cases within 60 days after evacuation of the mole and in 19.6% between 61 and 140 days. There were 22 (7.1%) patients diagnosed as having gestational trophoblastic tumors (GTT) and treated with chemotherapy: 20 were complete moles and 2 partial moles. Considering these data, the authors suggest different follow-up times for partial and complete moles and confirm the necessity of selection criteria in a diagnosis of GTT.

scholarly journals A Case of Rapid Transformation from Hydatidiform Mole to Invasive Mole: The Importance of β-hCG (Human Chorionic Gonadotropin) Serum Levels in Follow-Up Evaluation

2021 ◽  
Vol 22 ◽  
Author(s):  
Ali Budi Harsono ◽  
Yudi Mulyana Hidayat ◽  
Gatot Nyarumenteng Adhipurnawan Winarno ◽  
Aisyah Shofiatun Nisa ◽  
Firas Farisi Alkaff
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Hydatidiform Mole ◽  
Serum Levels ◽  
Β Hcg ◽  
Invasive Mole ◽  
Rapid Transformation

scholarly journals Recurrent Molar Pregnancy: An Obstetric Dilemma?

2012 ◽  
Vol 3 (2) ◽  
pp. 63-64 ◽  
Author(s):  
Lakshmi Rathna Marakani ◽  
Sirisha Rao Gundabattula
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Nulliparous Woman ◽  
Molar Pregnancy ◽  
Persistent Disease ◽  
Beta Human Chorionic Gonadotropin ◽  
Β Hcg

ABSTRACT Approximately 1% of women with a molar pregnancy may have a recurrence. Chemotherapy is not indicated for recurrent molar pregnancies. An adequate interconception interval is important to ensure that the serum beta-human chorionic gonadotropin (β-hCG) from a new pregnancy does not interfere with the follow-up of the molar pregnancy that is done to detect persistent disease. We discuss the case of a nulliparous woman who had four molar pregnancies and her future reproductive options. How to cite this article Marakani LR, Gundabattula SR. Recurrent Molar Pregnancy: An Obstetric Dilemma? Int J Infertility Fetal Med 2012;3(2):63-64.

scholarly journals Serum β-hCG Levels Between 13-20 Weeks Gestation Can Predict Development of Pregnancy Induced Hypertension

2018 ◽  
Vol 13 (1) ◽  
pp. 12-14
Author(s):  
Gurpreet Kour ◽  
Sandeep Kour
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Predictive Value ◽  
Pregnancy Induced Hypertension ◽  
Median Score ◽  
Pregnant Females ◽  
Induced Hypertension ◽  
Β Hcg

Aims: To find out predictive value of Serum β Human Chorionic Gonadotropin (β HCG) levels between 13-20 weeks of gestation in predicting the development of pregnancy induced hypertension (PIH) or pre-eclampsia, eclampsia.Methods: Serum β HCG level was estimated in 200 normotensive patients between 13-20 weeks of gestation. The median value of Serum β HCG was calculated and patients were divided into two groups as per two times Multiple of Median (2MOM) values of Serum β HCG i.e. those above and below the 2MOM values. The patients were followed up to delivery and were evaluated for the development of PIH, pre-eclampsia and eclampsia.Results: As per the median score of Serum β HCG in studied patients, the determined value of 2MOM was 30845 mIU/ml.  Out of 200 patients, 23 (11.5%) patients were found to have values of Serum β HCG ≥ 2MOM. Twelve (52%) patients in Serum β HCG ≥ 2MOM group developed hypertension on follow up as compared to 13 (7.3%) patients in < 2MOM group (p< 0.0001). Also patients in the ≥ 2MOM group had higher prevalence of maternal and fetal complications.Conclusion: Serum β HCG levels between 13-20 weeks of gestation can predict development of PIH  in pregnant females

Placental Site Trophoblastic Tumors: Analysis of the Clinicopathologic Characteristics of 20 Cases in Korea

2016 ◽  
Vol 26 (8) ◽  
pp. 1515-1520 ◽  
Author(s):  
Min Chul Choi ◽  
Sang Geun Jung ◽  
Hyun Park ◽  
Won Duk Joo ◽  
Chan Lee ◽  
...  
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Early Stage ◽  
Clinicopathologic Characteristics ◽  
Early Stage Disease ◽  
Presenting Symptoms ◽  
Gynecology And Obstetrics ◽  
Trophoblastic Tumors ◽  
Placental Site

ObjectivesThe aim of this study was to evaluate the clinicopathologic features of placental site trophoblastic tumors (PSTTs) in Korea.Methods/MaterialsTwenty patients given a diagnosis of PSTT in Korea (1990–2013) were evaluated retrospectively, including 14 patients identified through a literature review and 6 patients identified through a medical chart review of a single institution. The analysis included patient age, antecedent pregnancies, time since antecedent pregnancy, presenting symptoms, serum β-human chorionic gonadotropin level, International Federation of Gynecology and Obstetrics stage, treatment, outcome, and follow-up.ResultsThe mean age of the 20 patients was 32 years (range, 25–53 years). The antecedent pregnancies included 8 term pregnancies, 8 abortions, and 2 molar pregnancies. The time since the antecedent pregnancy was less than 1 year in 16 patients (80%). Nineteen patients (95%) presented with abnormal vaginal spotting or amenorrhea. Serum β-human chorionic gonadotropin levels ranged from normal to 13,480 mIU/mL, although most patients (80%) had a level less than 1000 mIU/mL. Seventeen patients (85%) presented with stage I disease. Ten patients (50%) underwent hysterectomy, and 14 patients (70%) were treated with chemotherapy with or without hysterectomy. In 11 evaluated patients, the median mitotic count index was 3.4 (0.4–10) per 10 high-power fields. The median follow-up time was 17 months (range, 1–68 months). There was no recurrence or death from disease.ConclusionsKorean patients with PSTT often have early-stage disease, which has a favorable prognosis even with fertility-preserving therapy. However, international studies are necessary to determine the optimal treatment and prognostic factors.

scholarly journals Epithelioid trophoblastic tumor coexisting with choriocarcinoma around an abdominal wall cesarean scar: a case report and review of the literature

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Chunfeng Yang ◽  
Jianqi Li ◽  
Yuanyuan Zhang ◽  
Hanzhen Xiong ◽  
Xiujie Sheng
Keyword(s):  
Abdominal Wall ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Unknown Origin ◽  
Exploratory Laparotomy ◽  
Cesarean Scar ◽  
Trophoblastic Tumor ◽  
Epithelioid Trophoblastic Tumor ◽  
Trophoblastic Tumors ◽  
Wall Lesion

Abstract Background Mixed gestational trophoblastic neoplasms are extremely rare and comprise a group of fetal trophoblastic tumors including choriocarcinomas, epithelioid trophoblastic tumors, and placental site trophoblastic tumors. We present a case of a patient with extrauterine mixed gestational trophoblastic neoplasm adjacent to the abdominal wall cesarean scar. On the basis of a literature review, this type of case has never been reported before due to the unique lesion location and low incidence. Case presentation Our patient was a 39-year-old Chinese woman who had a history of two cesarean sections and one miscarriage. She had a recurrent anterior abdominal wall mass around her cesarean scar, and the mass was initially suspected of being choriocarcinoma of unknown origin. The patient had concomitant negative or mildly increased serum β-human chorionic gonadotropin at follow-up and no abnormal vaginal bleeding or abdominal pain. However, she underwent local excision twice and had two courses of chemotherapy with an etoposide and cisplatin regimen. She finally opted for exploratory laparotomy with abdominal wall lesion removal, subtotal hysterectomy, bilateral salpingectomy, and left ovarian cyst resection, which showed the abdominal wall lesion, whose components were revealed by microscopy and immunohistochemical staining to be approximately 90% epithelioid trophoblastic tumors and 10% choriocarcinomas from a solely extrauterine mixed gestational trophoblastic neoplasm around an abdominal wall cesarean scar. Conclusions It is worth noting whether epithelioid trophoblastic tumor exists in the setting of persistent positive low-level β-human chorionic gonadotropin. More studies are required to provide mechanistic insights into these mixed gestational trophoblastic neoplasms.

scholarly journals Lung neoplasm mimicking as ectopic pregnancy due to paraneoplastic secretion of human chorionic gonadotropin: a case report and literature review

2021 ◽  
Author(s):  
Jin Peng ◽  
Shangge lv ◽  
Lin Liu ◽  
Shuai Feng ◽  
Naidong Xing
Keyword(s):  
Systematic Review ◽  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Lung Neoplasm ◽  
High Serum ◽  
Pregnancy Test ◽  
Positive Pregnancy Test ◽  
Β Hcg ◽  
Present Systematic Review

Abstract Purpose The present systematic review aimed to examine the relationship between lung neoplasm and human chorionic gonadotropin (HCG). Especially, women with lung neoplasm mimicking as ectopic pregnancy were explored. Methods A rare case of lung neoplasm with high serum β-HCG, which was initially thought to be ectopic pregnancy, was reported. A literature search was performed of the US National Library of Medicine (MEDLINE), EMBASE, PubMed, and the Cochrane Database of Systematic Reviews using appropriate keywords and subject headings to February 2020. Results Studies assessed lung neoplasm patients with positive HCG were included. Twenty studies, including 24 patients, were included. These cases illustrate the importance of considering the possibility of paraneoplastic secretion of β-HCG in patients who have a positive pregnancy test. This may prevent a delay in the diagnosis and treatment of malignancy in young women. Of the 24 cases, only 7 (29.17%) were managed surgically; others were managed conservatively or with chemotherapy or radiation. Conclusion The present systematic review shows the need to re-awaken awareness and high index of suspicion to lung neoplasm diagnosis in patients with positive pregnancy test.

scholarly journals The human chorionic gonadotropin test is more powerful than the gonadotropin-releasing hormone agonist test to discriminate male isolated hypogonadotropic hypogonadism from constitutional delayed puberty

2003 ◽  
pp. 23-29 ◽  
Author(s):  
V Degros ◽  
C Cortet-Rudelli ◽  
B Soudan ◽  
D Dewailly
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Testosterone Level ◽  
Pubertal Development ◽  
Hypogonadotropic Hypogonadism ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Delayed Puberty ◽  
Hcg Test

OBJECTIVE: The effectiveness of biological investigations aiming at discriminating isolated hypogonadotropic hypogonadism (IHH) from constitutional delayed puberty (CDP) in male patients is still controversial. We revisited the diagnostic power of the basal serum testosterone level, the Triptorelin test and the human chorionic gonadotropin (hCG) test in a cohort of 33 boys with delayed puberty. DESIGN: Boys were aged 14.2 to 26.2 Years at referral. A 5-Year-long clinical follow-up after the initial study allowed confirmation of the diagnosis. At the end of the follow-up period, IHH was found in 13 patients while the other 20 had normal spontaneous pubertal development (CDP). RESULTS: At referral, a basal morning testosterone level >1.7 nmol/l was observed in 55% of patients with CDP exclusively (predictive positive value (PPV)=100%; predictive negative value (PNV)=59%). For CDP, the PPV of the LH peak 3 h after Triptorelin was 100% by setting the upper threshold at 14 IU/l and the PNV was 72%. However, no lower threshold could discriminate IHH from CDP in the remaining patients with an LH peak 3 h after Triptorelin <14 IU/l. In CDP patients, the PPV of the serum testosterone increment after hCG stimulation (deltaT/hCG) was 100% for values >9 nmol/l (PNV=72%). In IHH patients, the PPV of deltaT/hCG was 100% for values <3 nmol/l (PNV=82%). Only 29% of the studied population had a deltaT/hCG between these lower and upper thresholds and therefore could not have been classified initially. CONCLUSIONS: (i) Dynamic testing for the diagnosis of delayed puberty is useful only when the basal testosterone level is lower than 1.7 nmol/l; (ii) in that case, the hCG test has better discriminating power than the Triptorelin test and appears as the best cost-effective investigation. It prevents useless and expensive investigations in about one-half of CDP patients with a basal morning testosterone level lower than 1.7 nmol/l.

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