Differences in Total Human Chorionic Gonadotropin Immunoassay Analytical Specificity and Ability to Measure Human Chorionic Gonadotropin in Gestational Trophoblastic Disease and Germ Cell Tumors

摘要

OBJECTIVE: To determine the ability of several ra-dioimmunoassays and commercial two-site immunoas-says to detect the first World Health Organization International Reference Reagents (IRRs) for 6 defined human chorionic gonadotropin (hCG) variants and to compare their performance in measuring hCG in sera from patients with gestational trophoblastic disease (GTD) and germ cell tumors (GCTs) of the testis or ovary. STUDY DESIGN: The reactivity of the different assays with the 6 IRRs together with the current fourth International Standard (IS, 75/589) was tested using 5 commercial two-site assays aswell as 2 competitive polyclonal radioimmunoassays (RIAs) .and a competitive monoclonal immunoassay. Individual samples from 41 patients (19 GCTand 22 GTD)with high circulating levels of hCG (range, 718-6,055,000 IU/L) were diluted and measured using the various immunoassays. RESULTS: The results of 4 GCT patient samples varied markedly among the assays, including 1 sample that was grossly underestimated by 3 of the commercial assays.CONCLUSION: Comparison of each assay's reactivity to the variant isoforms revealed that recognition of the isoforms was highly variable, particularly for hCGbeta and hCGbeta core fragment (hCGbetacf).