Clinical use of HCG and hCG beta determinations

Recent advances in our understanding of hCG/hCG beta synthesis by trophoblastic and nontrophoblastic tissues together with improved techniques for measuring hCG have helped to define the role of hCG as a clinical marker. HCG determination by sensitive immunometric assay enables detection of hCG immunoreactivity in normal men and women. It facilitates early detection of normal pregnancy and significantly contributes to the diagnosis of various pregnancy-related disorders, such as ectopic pregnancy, spontaneous abortion, hydatidiform mole, choriocarcinoma or Trisomy 21. Further, determination of this marker is immensely helpful to guide curative intervention in testicular cancer. For diagnosis and follow-up of patients with testicular cancer, a method measuring both hCG and hCG beta or separate methods for each component are recommended, because a significant portion of seminoma exclusively secrete free hCG beta. Also, hCG beta production by other than trophoblastic malignancies has been well recognized. A possible clinical use of hCG beta as a marker of cancers of the bladder, pancreas or biliary tract is currently debated.