Clinical significance and pitfalls of human chorionic gonadotropin
related tumor markers for intracranial germinomas
Abstract
Objective Measuring serum and cerebrospinal fluid human
chorionic gonadotropin (hCG) is essential for the diagnosis of
intracranial germ cell tumors. There are three types of hCG-related
markers in clinical use: hCGβ, intact hCG, and total hCG. The best
marker for the diagnosis of intracranial germ cell tumors, especially
germinoma, is currently unknown. This study aimed to evaluate the
usefulness of these hCG-related markers. Materials and Methods
We report six patients with histologically diagnosed germinoma treated
at our institute. Serum hCGβ, intact hCG, and total hCG were measured
before, during, and after treatment. Results The positivity
rates of serum hCGβ, intact hCG, and total hCG were 6% (1/17), 47%
(7/15), and 42% (8/19), respectively, with the latter two having
significantly higher positivity rates than hCGβ (p = 0.041). Both intact
and total hCGs showed similar values. The median value of hCGβ, intact
hCG, and total hCG before treatment was 0.1 ng/mL, 4.6 mIU/mL, and
4.5 mIU/mL, respectively. Conclusion Serum intact and total
hCGs have higher detection rates than hCGβ for patients with germinoma
using available commercial measurement tools.