Beta-human chorionic gonadotropin

Beta human chorionic gonadotropin (β-hCG) levels in germinomas and embryonal carcinomas are inconsistent but are usually more detectable in cerebrospinal fluid. High βhCG levels in germinomas have been associated with a worse prognosis.


Elevated CSF beta human chorionic gonadotropin](β-hCG) is classically associated with choriocarcinomas but also occurs with up to 50% of germinomas (which are more common).

Diagnostic marker

Elevated Beta Human chorionic gonadotropin occurs with up to 50 % of germinomas.

Marked elevations of AFP and bHCG in serum or CSF may serve as surrogate diagnostic markers in lieu of histology for primary CNS mixed, malignant germ cell tumors. Lumbar CSF was a more informative screen for bHCG than serum but the majority of patients (60%) had normal bHCG values at diagnosis. Until a more sensitive tumor marker for germinoma is devised, histologic confirmation remains the standard of care 1).

CSF hCG assay is a sensitive method for diagnosing intracranial ectopic germinoma 2).

1)
Allen J, Chacko J, Donahue B, Dhall G, Kretschmar C, Jakacki R, Holmes E, Pollack I. Diagnostic sensitivity of serum and lumbar CSF bHCG in newly diagnosed CNS germinoma. Pediatr Blood Cancer. 2012 Dec 15;59(7):1180-2. doi: 10.1002/pbc.24097. Epub 2012 Feb 2. PubMed PMID: 22302772; PubMed Central PMCID: PMC3356788.
2)
Tian C, Shi Q, Pu C, Huang X, Yu S, Zhang J, Huang D, Wang X, Liu R. Re-evaluation of the significance of cerebrospinal fluid human chorionic gonadotropin in detecting intracranial ectopic germinomas. J Clin Neurosci. 2011 Feb;18(2):223-6. doi: 10.1016/j.jocn.2010.04.041. Epub 2010 Dec 15. PubMed PMID: 21163658.