Gestational trophoblastic diseases: 4. Presentation with persistent low positive human chorionic gonadotropin test results

Gynecologic Oncology
Laurence A ColeErnest Kohorn

Abstract

A high proportion of women with persistent low levels of hCG, in the absence of pregnancy or any evidence of tumor, have received chemotherapy and hysterectomy for assumed malignancy. Such chemotherapy and surgery were ineffective and unwarranted. This study identifies the causes of persistent low level of hCG and provides guidelines for the management of these patients, preventing unnecessary treatment in the future. The USA hCG Reference Service has consulted on 170 women with low levels of hCG persisting for 3 months or longer. Serum total hCG was measured in the Diagnostic Products Corporation (DPC) Immulite assay and hyperglycosylated hCG in the Nichols Advantage test. Among these 170 patients, the average persistent hCG result was 102 +/- 152 mIU/ml, with a range of 6.1-900 mIU/ml. Thirteen (7.6%) of the 170 patients had true malignancy, 5 had placental site trophoblastic tumor, 3 had other gestational trophoblastic neoplasms (GTN), and 5 had non-trophoblastic malignancies. The remaining 157 patients had false-positive hCG, quiescent gestational trophoblastic disease (quiescent GTD), or pituitary hCG (hCG of pituitary origin). Of 71 patients with false-positive hCG, 47 patients received chemotherapy and 9 had surgery that...Continue Reading

References

Sep 16, 2003·Clinical Obstetrics and Gynecology·Laurence A Cole, Jaime M Sutton

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Citations

Feb 18, 2014·Current Obstetrics and Gynecology Reports·Siew-Fei Ngu, Karen K L Chan
Jan 28, 2009·Reproductive Biology and Endocrinology : RB&E·Laurence A Cole
Mar 16, 2007·The New England Journal of Medicine·Laurence A ColeCarolyn Y Muller
Dec 8, 2009·Gynecologic Oncology·Diljeet K Singh, John R Lurain
Nov 26, 2008·Clinical Biochemistry·Laurence A Cole, Sarah A Khanlian
Nov 15, 2008·Gynecologic Oncology·Carolyn Y Muller, Laurence A Cole
May 8, 2007·Gynecologic Oncology·Carlo PalmieriMichael J Seckl
Mar 10, 2007·Placenta·L A Cole
Mar 4, 2008·American Journal of Obstetrics and Gynecology·Laurence A ColeCarolyn Y Muller
Feb 27, 2016·The Journal of Obstetrics and Gynaecology Research·Xue-Qian QianXiao-Yun Wan
May 25, 2010·Clinical Biochemistry·Laurence A ColeCarolyn Y Muller
Sep 9, 2017·Obstetrics and Gynecology·Samuel I McCashLakshmi V Ramanathan
Jan 17, 2016·BJOG : an International Journal of Obstetrics and Gynaecology·F TaylorR E Coleman
Mar 9, 2020·BJOG : an International Journal of Obstetrics and Gynaecology·P SavageM J Seckl
Dec 10, 2009·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Laurence A ColeCarolyn Y Muller
Jan 2, 2021·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Lua EirikssonPhilippe Sauthier
Nov 1, 2016·The Journal of Applied Laboratory Medicine·Anna E MerrillDina N Greene

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