title: Human chorionic gonadotropin detection in cerebrospinal fluid of patients with a germinoma and its prognostic significance: assessment by using a highly sensitive enzyme immunoassay.
abstract: OBJECTIVE Human chorionic gonadotropin (HCG) can be detected in a certain population of patients with a germinoma, but the frequency of germinoma HCG secretion and the prognostic value of HCG in the CSF are unknown. METHODS The authors measured HCG levels in sera and CSF in patients with a histologically confirmed germinoma by using a highly sensitive assay known as an immune complex transfer enzyme immunoassay (EIA), which is more than 100 times as sensitive as the conventional method, and they analyzed the correlation between HCG levels and the prognoses of patients with a germinoma. RESULTS HCG levels in sera and CSF of 35 patients with a germinoma were examined with the immune complex transfer EIA. The median CSF HCG levels in patients with a germinoma during the pretreatment and posttreatment evaluations were 192.5 pg/ml (range 1.2-13,116.5 pg/ml) and 18.7 pg/ml (1.2-283.9 pg/ml), respectively. Before treatment, the CSF HCG level was greater than the cutoff value in 85.7% of the patients with a germinoma. The authors compared survival rates among the patients by using a CSF HCG cutoff level of 1000 pg/ml, and the difference was statistically significant between the groups (p = 0.029, log-rank test). CONCLUSIONS Results of this study demonstrate that most germinomas secrete HCG. Patients with a germinoma that secretes higher amounts of HCG in their CSF experienced recurrence more frequently than those with lower CSF HCG levels.
authors.affiliation: Division of Pediatric Neuro-Oncology, Department of Neuro-Oncology/Neurosurgery, and.
authors.forename: Kohei
authors.initials: K
authors.lastname: Fukuoka
authors.affiliation: Division of Pediatric Neuro-Oncology, Department of Neuro-Oncology/Neurosurgery, and.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Yanagisawa
authors.affiliation: Division of Pediatric Neuro-Oncology, Department of Neuro-Oncology/Neurosurgery, and.
authors.forename: Tomonari
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Hidaka.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Shirahata
authors.affiliation: Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Hidaka.
authors.forename: Jun-Ichi
authors.initials: JI
authors.lastname: Adachi
authors.affiliation: Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Hidaka.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Mishima
authors.affiliation: Department of Neurosurgery, Saitama Medical University Hospital, Moroyama; and.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Fujimaki
authors.affiliation: Division of Clinical Research Sciences, Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Katakami
authors.affiliation: Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Hidaka.
authors.forename: Masao
authors.initials: M
authors.lastname: Matsutani
authors.affiliation: Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Hidaka.
authors.forename: Ryo
authors.initials: R
authors.lastname: Nishikawa
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood / Q000134:cerebrospinal fluid*; D001932:Brain Neoplasms / Q000097:blood / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D002648:Child; D006063:Chorionic Gonadotropin / Q000097:blood / Q000134:cerebrospinal fluid*; D015331:Cohort Studies; D005260:Female; D018237:Germinoma / Q000097:blood / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis; D011379:Prognosis; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin
keywords: AFP = alpha-fetoprotein; CARE = carboplatin and etoposide; CR = complete response; EIA = enzyme immunoassay; GCT = germ cell tumor; HCG = human chorionic gonadotropin; ICT = immune complex transfer; NGGCT = nongerminomatous GCT; germinoma; human chorionic gonadotropin; oncology; prognosis