Beta-HCG (BHCG, Tumour marker)
Chemical Pathology
Notes
As with most tumour markers there is a high incidence of false positive and false negative results; HCG is most appropriately used in monitoring disease progression or effectiveness of treatment once diagnosis of the tumour has been made and serum concentrations have been shown to be high prior to treatment.
HCG can be secreted by abnormal germ cell, placental or embryonal tissues especially seminomatous and non-seminomatous testicular tumours (NSGCT), ovarian germ cell tumours, gestational trophoblastic disease (GTD - hydatiform mole and choriocarcinoma) and benign or malignant non-testicular teratomas.
In NSGCT HCG is used in combination with AFP and LDH. LDH and HCG are used in seminomas.
Rarely other tumours including hepatic, neuroendocrine, breast, ovarian, pancreatic, cervical and gastric cancers may secrete HCG but usually in smaller amounts and there are other better markers for these tumours.
Sample requirements
If patient on high dose biotin therapy (>5mg/day) collect sample at least 8 hours after the last dose.
For adults, blood taken into a 5mL gold top tube (or rust top for the Acute Unit)
Storage/transport
Send at ambient temperature to the laboratory. If unavoidable, samples can be stored refrigerated overnight.
Required information
Relevant clinical details, including the reason for the request; the site of the primary tumour; whether the test is being used as a baseline prior to treatment or for follow-up.
Turnaround times
The assays are run throughout the day Monday to Friday.
The in-lab turnaround time is normally less than 4 days.
Please note that there is a National UK GTD Service responsible for registering and monitoring all women with GTD at Imperial College Healthcare NHS Trust with samples sent direct by post by patients once registered. For inpatients samples may be referred there if appropriate with results expected in 10 days.
Reference ranges
Assayed at GHNHSFT using the Cobas Intact human chorionic gonadotropin + the beta subunit ECLIA:
- Males: less than 2 IU/L
Serum hCG levels in healthy women:
Non-pregnant premenopausal women: 97.5% of women have results ≤ 1 IU/L
Postmenopausal women: 97.5% of women have results ≤ 7 IU/L
(For samples referred for analysis to Imperial College Healthcare Trust: less than 5 IU/L)
Further information
Charing Cross Hospital Trophoblast Disease Service
Analyte Monograph alongside the National Laboratory Medicine Handbook
Page last updated 05/06/2018