Cole Laurence A, Butler Stephen
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, 2211 Lomas Boulevard Northeast, ACC-4th Floor, Albuquerque, NM 87131-5286, USA.
J Reprod Med. 2002 Jun;47(6):433-44.
hCG is a glycoprotein hormone composed of two dissimilar subunits. This hormone is not only heterogeneous in peptide structure but also in combination of subunits and carbohydrate structure. Common hCG-related molecules include hCG, hyperglycosylated hCG, nicked hCG, hCG missing the beta-subunit C-terminal peptide, free alpha-subunit, free beta-subunit, nicked free b-subunit and urine beta-core fragment. This article discusses the structures these hCG-related molecules and their occurrences in early pregnancy, 7-week to term pregnancy, hydatidiform mole (preevacuation and postevacuation), persistent gestational trophoblastic disease, choriocarcinoma and other malignancies. Multiple serum hCG tests are evaluated, and their abilities to detect the multiple hCG-related molecules are investigated. The accuracy of different serum hCG tests in detecting hCG and hCG-related molecules in patients with gestational trophoblastic diseases is evaluated. The findings of persistent low hCG values in the absence of pregnancy or an identifiable malignancy are examined. In addition, the false positive hCG assay problem is discussed. False positive hCG tests have led to many incidences in which gestational trophoblastic disease has been erroneously diagnosed and needlessly treated. hCG tests are identified that give a disproportionate number of false positive results. Finally, guidelines are presented for selecting an hCG test.
人绒毛膜促性腺激素（hCG）是一种由两个不同亚基组成的糖蛋白激素。这种激素不仅在肽结构上具有异质性，而且在亚基组合和碳水化合物结构上也存在差异。常见的与hCG相关的分子包括hCG、高糖基化hCG、缺口hCG、缺失β亚基C末端肽的hCG、游离α亚基、游离β亚基、缺口游离β亚基和尿β核心片段。本文讨论了这些与hCG相关分子的结构及其在早期妊娠、妊娠7周直至足月、葡萄胎（排空前和排空后）、持续性妊娠滋养细胞疾病、绒毛膜癌和其他恶性肿瘤中的出现情况。对多次血清hCG检测进行了评估，并研究了它们检测多种与hCG相关分子的能力。评估了不同血清hCG检测在检测妊娠滋养细胞疾病患者中hCG和与hCG相关分子的准确性。检查了在无妊娠或可识别的恶性肿瘤情况下持续低hCG值的情况。此外，还讨论了hCG检测假阳性的问题。hCG检测假阳性导致了许多妊娠滋养细胞疾病被误诊并接受不必要治疗的情况。确定了给出不成比例数量假阳性结果的hCG检测。最后，给出了选择hCG检测的指导原则。
