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13.09.2017 | Original Article – Clinical Oncology | Ausgabe 1/2018

Journal of Cancer Research and Clinical Oncology 1/2018

The usefulness of testosterone administration in identifying false-positive elevation of serum human chorionic gonadotropin in patients with germ cell tumor

Zeitschrift:
Journal of Cancer Research and Clinical Oncology > Ausgabe 1/2018
Autoren:
Akitoshi Takizawa, Koji Kawai, Takashi Kawahara, Takahiro Kojima, Satoru Maruyama, Nobuo Shinohara, Shusuke Akamatsu, Tomomi Kamba, Terukazu Nakamura, Osamu Ukimura, Ryosuke Jikuya, Takeshi Kishida, Kenichi Kakimoto, Kazuo Nishimura, Toru Harabayashi, Satoshi Nagamori, Shinichi Yamashita, Yoichi Arai, Yoshitomo Sawada, Noritoshi Sekido, Hidefumi Kinoshita, Tadashi Matsuda, Tohru Nakagawa, Yukio Homma, Hiroyuki Nishiyama

Abstract

Objective

The pituitary production of human chorionic gonadotropin (hCG) can cause false-positive results during or after germ cell tumor (GCT) treatment. Because hypogonadism leads to pituitary hCG production, testosterone administration test (TAT) has been recommended for pituitary hCG diagnosis. However, little is known about its efficacy for the discrimination of pituitary hCG as detected by currently used hCG assays in treatment of GCT. We conducted a retrospective multicenter study to determine the usefulness of TAT.

Materials and methods

The study included 60 patients who underwent TAT for the discrimination of pituitary hCG. In principle, serum hCG levels were measured 1 week after testosterone enanthate administration (250 mg). When the serum hCG levels decreased below the normal upper range, the results of TAT were determined positive. In this case, the elevated hCG was considered to be derived from pituitary and not from GCT.

Results

Serum hCG levels were normalized after TAT in 36 of 60 patients (60%). Before TAT, the hCG levels were below 1.0 IU/L in 13 patients (36%), 1.0–1.9 IU/L in 11 (31%), 2.0–2.9 IU/L in 7 (19%), and >3.0 IU/L in 5 (14%) of TAT-positive patients. Of them, 28 (78%) patients were successfully managed without further treatment with chemotherapy after TAT. Pituitary hCG was associated with higher levels of LH and not necessarily associated with low levels of testosterone.

Conclusion

Determining the TAT status of patients was effective in discriminating pituitary hCG production.

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