4.5 Article

Proportion Hyperglycosylated hCG A New Test for Discriminating Gestational Trophoblastic Diseases

Journal

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER
Volume 24, Issue 9, Pages 1709-1714

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1097/IGC.0000000000000280

Keywords

hCG; Hyperglycosylated hCG; Hydatidiform mole; Choriocarcinoma

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Introduction: Hyperglycosylated human chorionic gonadotropin (hCG) is a variant of hCG with large oligosaccharide side chains. Although hCG is produced by syncytiotrophoblast cells, hyperglycosylated hCG marks cytotrophoblast cell. Hyperglycosylated hCG signals placental implantation. Methods: Total hCG in serum and urine is measured by the Siemens Immulite hCG pregnancy test; the result is in milli-international unit per milliliter. Hyperglycosylated hCG is determined by the B152 microtiter plate assay; the result is in nanogram per milliliter. Hyperglycosylated hCG results can be converted to milli-international unit per milliliter equivalents by multiplying by 11. The test measures proportion hyperglycosylated hCG, hyperglycosylated hCG / total hCG. Results: Proportion hyperglycosylated hCG marks cases intent on developing persistent hydatidiform mole (68% detection at 17% false detection). Proportion hyperglycosylated hCG also marks persistent hydatidiform mole (100% detection at 5.1% false detection). Proportion hyperglycosylated hCG distinguishes choriocarcinoma and gestational trophoblastic neoplasm cases, absolutely discriminating aggressive cases and minimally aggressive cases. Proportion hyperglycosylated hCG identifies quiescent gestational trophoblastic disease cases. It recognizes quiescent cases that become persistent disease (100% detection at 0% false positive). Discussion: Proportion hyperglycosylated hCG is an invaluable test for discriminating gestational trophoblastic diseases.

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