Human chorionic gonadotrophin assays to monitor GTD

Hydatidiform mole (HM) occurs in 1:500-1000 pregnancies and are generally characterised as a benign proliferative disorder of chorionic villous trophoblast. HM belongs to the group of disorders, collectively known as gestational trophoblastic disease (GTD), which include invasive mole, choriocarcinoma, placental site trophoblastic tumour and epitheloid trophoblastic tumour. Patients with HM are at increased risk of developing these malignant forms and hence accurate diagnosis is very important for monitoring persistent diseases and informing correct patient management. In this review, we describe the current model for HM follow-up in the UK, with special emphasis on the in-house human chorionic gonadotrophin (hCG) radioimmunoassay (RIA) currently employed for monitoring women in our programme. We briefly discuss the structure, function and significance of hCG monitoring in GTD and the limitations and benefits of the current assays used for measuring oncology hCG. In particular, we describe the preliminary work evaluating a replacement antibody for the current gold-standard UK-RIA method.