The USA hCG Reference Service, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM 87131, USA.
Int J Gynecol Cancer. 2009 Dec;19(9):1556-9. doi: 10.1111/igc.0b013e3181a40cf2.
The normal pituitary production of human chorionic gonadotropin (hCG)alongside luteinizing hormone, and its presence in women after bilateral oophorectomy, during perimenopause and menopause, as measured in serum and urine, has been known for 30 years and is described in numerous publications. Last year our group discussed this finding in a correspondence to the editor in the March 15th issue of New England Journal of Medicine, yet the misinterpretation of low-level hCG in these women seems to have increased in magnitude.
This is an outcomes study of 36 cases of menopausal hCG referred to the USA hCG Reference Service over a 1-year period, from March 2007 to March 2008.
Eight cases occurred in women after oophorectomy, 28 were women in menopause/perimenopause. Surgery was postponed in 5 (14%) of 36 cases, and in 3 cases (8%), chemotherapy was unnecessarily administered. In 2 cases, computed tomography scans were cancelled. The average hCG detected was 10 +/- 7.2 IU/L in cases receiving an oophorectomy and 9.8 +/- 6.7 in perimenopause and 11 +/- 6.2 IU/L in menopause cases.
Low-level hCG production in woman in physiologic perimenopause, in menopause, or in women with prior bilateral oophorectomy is a normal biologic and biochemical phenomenon. Management protocols in all fields need to be changed to accept pituitary hCG as normal and recognize the clinical maneuvers that will secure the diagnosis. Understanding this physiology will avoid needless delays in necessary therapies such as organ transplant procedures and will limit the misadventure of prescribing unnecessary cancer treatments.
三十年来，人们已经知道，人类绒毛膜促性腺激素（hCG）与黄体生成素一起由垂体正常分泌，并且在女性双侧卵巢切除术后、围绝经期和绝经后，无论是血清还是尿液中都可检测到 hCG。在过去一年中，我们小组在《新英格兰医学杂志》3 月 15 日的一篇社论中对这一发现进行了讨论，但这些女性中低水平 hCG 的错误解读似乎在不断增加。
这是一项关于 36 例绝经后 hCG 的结果研究，这些病例是在 2007 年 3 月至 2008 年 3 月期间向美国 hCG 参考服务机构转诊的。
8 例发生在卵巢切除术后的女性中，28 例为绝经/围绝经期女性。在 36 例中，有 5 例（14%）推迟了手术，有 3 例（8%）接受了不必要的化疗。有 2 例取消了计算机断层扫描。接受卵巢切除术的病例 hCG 平均检测值为 10 ± 7.2 IU/L，围绝经期和绝经后病例的平均检测值为 9.8 ± 6.7 IU/L 和 11 ± 6.2 IU/L。
生理性围绝经期、绝经后或双侧卵巢切除术后女性的低水平 hCG 产生是一种正常的生物学和生物化学现象。所有领域的管理方案都需要改变，以接受垂体 hCG 为正常，并认识到将确保诊断的临床操作。了解这一生理学将避免不必要的延误，如器官移植程序的治疗，并将限制不必要的癌症治疗的错误冒险。
