Hydatidiform Mole Follow-up Service Scotland, Ninewells Hospital, and Medical School, Dundee, UK.
Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork and Department of Biochemistry & Cell Biology, University College Cork, Cork, Ireland.
Gynecol Obstet Invest. 2024;89(3):178-197. doi: 10.1159/000531499. Epub 2023 Jun 12.
The objective of this study was to collect information on human chorionic gonadotrophin (hCG) laboratory testing and reporting in women with gestational trophoblastic disease (GTD), to assess the associated challenges, and to offer perspectives on hCG testing harmonisation.
Information was collected from laboratories by electronic survey (SurveyMonkey) using a questionnaire designed by members of the European Organisation for the Treatment of Trophoblastic Disease (EOTTD) hCG working party.
The questionnaire was distributed by the EOTTD board to member laboratories and their associated scientists who work within the GTD field.
The questionnaire was distributed and accessed via an online platform.
The questionnaire consisted of 5 main sections. These included methods used for hCG testing, quality procedures, reporting of results, laboratory operational aspects, and non-GTD testing capability. In addition to reporting these survey results, examples of case scenarios which illustrate the difficulties faced by laboratories providing hCG measurement for GTD patient management were described. The benefits and challenges of using centralised versus non-centralised hCG testing were discussed alongside the utilisation of regression curves for management of GTD patients.
Information from the survey was collated and presented for each section and showed huge variability in responses across laboratories even for those using the same hCG testing platforms. An educational example was presented, highlighting the consequence of using inappropriate hCG assays on clinical patient management (Educational Example A), along with an example of biotin interference (Educational Example B) and an example of high-dose hook effect (Educational Example C), demonstrating the importance of knowing the limitations of hCG tests. The merits of centralised versus non-centralised hCG testing and use of hCG regression curves to aid patient management were discussed.
To ensure the survey was completed by laboratories providing hCG testing for GTD management, the questionnaire was distributed by the EOTTD board. It was assumed the EOTTD board held the correct laboratory contact, and that the questionnaire was completed by a scientist with in-depth knowledge of laboratory procedures.
The hCG survey highlighted a lack of harmonisation of hCG testing across laboratories. Healthcare professionals involved in the management of women with GTD should be aware of this limitation. Further work is needed to ensure an appropriate, quality-assured laboratory service is available for hCG monitoring in women with GTD.
本研究旨在收集有关妊娠滋养细胞疾病（GTD）患者人绒毛膜促性腺激素（hCG）实验室检测和报告的信息，评估相关挑战，并就 hCG 检测的协调提出看法。
通过电子调查（SurveyMonkey）从实验室收集信息，使用由欧洲滋养细胞疾病治疗组织（EOTTD）hCG 工作组成员设计的问卷。
EOTTD 委员会将问卷分发给其成员实验室及其在 GTD 领域工作的相关科学家。
问卷通过在线平台分发和访问。
问卷由 5 个主要部分组成。这些部分包括 hCG 检测方法、质量程序、结果报告、实验室操作方面以及非 GTD 检测能力。除了报告这些调查结果外，还描述了说明为 GTD 患者管理提供 hCG 测量时实验室面临困难的案例情景示例。讨论了使用集中式与非集中式 hCG 检测的优缺点，以及使用回归曲线管理 GTD 患者的情况。
对调查信息进行了整理和呈现，每个部分都显示出实验室之间的回复存在巨大差异，即使使用相同的 hCG 检测平台也是如此。提出了一个教育示例，强调了使用不合适的 hCG 检测对临床患者管理的后果（教育示例 A），以及生物素干扰的示例（教育示例 B）和高剂量钩状效应的示例（教育示例 C），说明了了解 hCG 检测局限性的重要性。讨论了集中式与非集中式 hCG 检测的优缺点以及使用 hCG 回归曲线辅助患者管理的问题。
为了确保参加 GTD 管理 hCG 检测的实验室完成调查，EOTTD 委员会分发了问卷。假设 EOTTD 委员会拥有正确的实验室联系人，并且问卷是由对实验室程序有深入了解的科学家填写的。
hCG 调查突出了实验室之间 hCG 检测缺乏协调。参与 GTD 妇女管理的医疗保健专业人员应意识到这一局限性。需要进一步努力，确保为 GTD 妇女的 hCG 监测提供适当的、经过质量保证的实验室服务。
