HCG in testicular cancer
Last reviewed 01/2018
Human chorionic gonadotrophin (HCG)
- HCG is normally synthesised in syncytiotrophoblasts of the placenta, and is also produced in malignancy, in trophoblastic structures or syncytiotrophoblastic giant cells of germ cell tumours (1,2). Some non-trophoblastic tumours synthesise hCG.
- very high serum HCG concentrations occur in hydatidiform moles ("molar" pregnancies) and choriocarcinomas (97%)
- serum HCG levels may be increased in pancreatic adenocarcinomas and islet cell tumours, tumours of the small and large bowel, hepatoma, stomach, lung, ovarian, breast and renal cancer
- for tumour marker use, measurement of both intact HCG and its free beta subunit (betaHCG) is highly desirable, as some tumours may produce only betaHCG
- increased serum HCG concentrations occur in both seminoma and non-seminomous germ cell tumours (NSGCT), with a diagnostic sensitivity of 40-60% in patients with metastatic NSGCT and 15-20% in those with metastatic seminoma. HCG elevations are predominantly found in patients with tumours containing choriocarcinomatous components, syncytiotrophoblastic giant cells and (more rarely) special round cells also found in pure seminomas.
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