Khanlian Sarah A, Cole Laurence A
USA hCG Reference Service, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque 87131-0001, USA.
J Reprod Med. 2006 Oct;51(10):812-8.
Recent publications show that the measurements of particular human chorionic gonadotropin (hCG) variants are extremely beneficial in the diagnosis, monitoring and treatment of gestational trophoblastic disease (GTD). Here we review the possible sources of hCG and the use of commercial tests in the optimal management of GTD, quiescent GTD,false positive hCG results, placental site trophoblastic tumor (PSTT) detection, nontrophoblastic neoplasms and pituitary hCG. Hyperglycosylated hCG (hCG-H) measurements are ideal for discriminating active (invasive) from inactive (quiescent or benign) disease. hCG-H testing is also more sensitive than regular hCG in detecting recurrent or persistent disease. After excluding false positive hCG results, and in the absence of any radiographic evidence of tumor, hCG-H should be measured before starting chemotherapy or surgery in women presenting with low hCG (<1,000 mIU/mL) with or without a history of GTD. The hCG free beta assay is an invaluable test in discriminating PSTT from other GTDs, thereby aiding the determination of appropriate treatment options.
近期发表的文献表明，特定人绒毛膜促性腺激素（hCG）变体的检测在妊娠滋养细胞疾病（GTD）的诊断、监测及治疗中极为有益。在此，我们回顾hCG的可能来源以及商业检测在GTD的最佳管理、静止性GTD、hCG假阳性结果、胎盘部位滋养细胞肿瘤（PSTT）检测、非滋养细胞肿瘤及垂体hCG方面的应用。高糖基化hCG（hCG-H）检测对于区分活动性（侵袭性）疾病与非活动性（静止性或良性）疾病非常理想。hCG-H检测在检测复发或持续性疾病方面也比常规hCG更为敏感。在排除hCG假阳性结果且无任何肿瘤影像学证据的情况下，对于hCG水平低（<1,000 mIU/mL）且有或无GTD病史的女性，在开始化疗或手术前应检测hCG-H。游离β-hCG检测在鉴别PSTT与其他GTD方面是一项极有价值的检测，从而有助于确定合适的治疗方案。
