Hirokazu Usui , Atsuko Mikiya , Eri Katayama , Natsuko Nakamura , Asuka Sato , Hideo Matsui , Makio Shozu , Kaori Koga
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We focused on cases where both total hCG (mIU/mL) and the free β-subunit of hCG (ng/mL) were measured on the same day.</p></div><div><h3>Results</h3><p>Out of 80 patients (mean age 38.9 ± 11.7 years) and 158 measurements, 26 had values below the sensitivity threshold for both tests. Fifty-nine measurements were positive for total hCG but below the sensitivity threshold for the free β-subunit of hCG, whereas only two showed the opposite. Seventy-one measurements were positive for both total hCG and the free β-subunit of hCG. There was a significant correlation between total hCG and the free β-subunit of hCG with both positive values, (r = 0.94, p < 0.001; Spearman's correlation test). Of the 85 measurements with undetectable free β-subunit levels, 26 also had undetectable total hCG levels. 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引用次数: 0
摘要
目的人绒毛膜促性腺激素(hCG)水平对滋养细胞疾病的治疗至关重要。本研究旨在比较两种hCG测量方法(总hCG和hCG游离β-亚基)在妊娠滋养细胞疾病(GTD)诊断中的敏感性和相关性。设计与方法我们分析了2008年至2019年在千叶大学医院接受GTD治疗的患者的数据。我们关注的是同一天测量总hCG (mIU/mL)和hCG游离β-亚单位(ng/mL)的病例。结果80例患者(平均年龄38.9±11.7岁)158次检测中，26例两项检测均低于敏感阈值。59项测量显示总hCG阳性，但低于hCG自由β亚基的敏感阈值，而只有2项显示相反。71例hCG总量和游离β- hCG亚基均呈阳性。总hCG与hCG游离β-亚基均呈阳性，相关性显著(r = 0.94, p <0.001;Spearman相关检验)。在85个检测不到游离β亚基水平的测量中，26个也检测不到总hCG水平。然而，这些病例中有59例患者可检测到总hCG，中位数(四分位数范围)为2.9 (1.75-4.9)mIU/mL。结论在GTD的治疗中，不建议单独使用游离β-亚基系统。
Total human chorionic gonadotropin is a more suitable diagnostic marker of gestational trophoblastic diseases than the free β-subunit of human chorionic gonadotropin
Objectives
Human chorionic gonadotropin (hCG) levels are essential for the management of trophoblastic diseases. This study aimed to compare the sensitivities and relationships of two hCG measurement methods (total hCG and the free β-subunit of hCG) in managing gestational trophoblastic disease (GTD).
Design and Methods
We analyzed data from patients treated for GTD at Chiba University Hospital between 2008 and 2019. We focused on cases where both total hCG (mIU/mL) and the free β-subunit of hCG (ng/mL) were measured on the same day.
Results
Out of 80 patients (mean age 38.9 ± 11.7 years) and 158 measurements, 26 had values below the sensitivity threshold for both tests. Fifty-nine measurements were positive for total hCG but below the sensitivity threshold for the free β-subunit of hCG, whereas only two showed the opposite. Seventy-one measurements were positive for both total hCG and the free β-subunit of hCG. There was a significant correlation between total hCG and the free β-subunit of hCG with both positive values, (r = 0.94, p < 0.001; Spearman's correlation test). Of the 85 measurements with undetectable free β-subunit levels, 26 also had undetectable total hCG levels. However, total hCG was detectable in 59 patients from these cases, with a median value (interquartile range) of 2.9 (1.75–4.9) mIU/mL.
Conclusions
In the management of GTD, the use of the free β-subunit system alone cannot be recommended.
期刊介绍：
Practical Laboratory Medicine is a high-quality, peer-reviewed, international open-access journal publishing original research, new methods and critical evaluations, case reports and short papers in the fields of clinical chemistry and laboratory medicine. The objective of the journal is to provide practical information of immediate relevance to workers in clinical laboratories. The primary scope of the journal covers clinical chemistry, hematology, molecular biology and genetics relevant to laboratory medicine, microbiology, immunology, therapeutic drug monitoring and toxicology, laboratory management and informatics. We welcome papers which describe critical evaluations of biomarkers and their role in the diagnosis and treatment of clinically significant disease, validation of commercial and in-house IVD methods, method comparisons, interference reports, the development of new reagents and reference materials, reference range studies and regulatory compliance reports. Manuscripts describing the development of new methods applicable to laboratory medicine (including point-of-care testing) are particularly encouraged, even if preliminary or small scale.
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