Significance of simultaneous determination of serum human chorionic gonadotropin (hCG) and hCG-beta in testicular tumor patients

Background: Simultaneous determinations of human chorionic gonadotropin hor mone (hCG) and hCG-beta frequently produce discrepancies, that is when hCG or hCG-beta is normal, the other is elevated. Accordingly, we examined the significance of simultaneous determination of serum hCG and hCG-beta in tes ticular tumors. Methods: Simultaneous determination of hCG and hCG-beta was performed in 54 patients with testicular seminoma and 74 with non-seminomatous testicular tumors. Results: For detection of seminoma patients, hCG-beta was more effective th an hCG because hCG-beta was positive in 83% (45/54) of the patients and hCG was positive in 50% (27/54). In nonseminomatous testicular tumor cases, hC G-beta was positive in 74% (55/74) and hCG was positive in 82% (61/74). The cases of hCG < 1.0 mIU/mL and HCG-beta > 0.1 ng/mL were significantly more frequently seen in patients with seminoma than in those with non-seminomat ous testicular tumor (P < 0.001). Fourteen patients had recurrent tumor. At recurrence, only hCG was elevated in nine cases, only hCG-beta was elevate d in two cases and both in one case. For diagnosis of falsely positive hCG, testosterone administration was effective because after testosterone admin istration, serum hCG levels became undetectable (< 1.0 mIU/mL) within one w eek in three examined cases. Conclusion: Human chorionic gonadotropin-beta was a better marker of semino ma than hCG. For earlier detection of recurrence, both markers should be ex amined. For diagnosis of falsely positive hCG, testosterone administration was effective.