TY - JOUR
T1 - The usefulness of testosterone administration in identifying false-positive elevation of serum human chorionic gonadotropin in patients with germ cell tumor
AU - Takizawa, Akitoshi
AU - Kawai, Koji
AU - Kawahara, Takashi
AU - Kojima, Takahiro
AU - Maruyama, Satoru
AU - Shinohara, Nobuo
AU - Akamatsu, Shusuke
AU - Kamba, Tomomi
AU - Nakamura, Terukazu
AU - Ukimura, Osamu
AU - Jikuya, Ryosuke
AU - Kishida, Takeshi
AU - Kakimoto, Kenichi
AU - Nishimura, Kazuo
AU - Harabayashi, Toru
AU - Nagamori, Satoshi
AU - Yamashita, Shinichi
AU - Arai, Yoichi
AU - Sawada, Yoshitomo
AU - Sekido, Noritoshi
AU - Kinoshita, Hidefumi
AU - Matsuda, Tadashi
AU - Nakagawa, Tohru
AU - Homma, Yukio
AU - Nishiyama, Hiroyuki
N1 - Publisher Copyright:
© 2017, Springer-Verlag GmbH Germany.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - False positive
KW - Pituitary hCG
KW - Testicular germ cell tumor
KW - hCG
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U2 - 10.1007/s00432-017-2520-5
DO - 10.1007/s00432-017-2520-5
M3 - Article
C2 - 28905168
AN - SCOPUS:85029457198
VL - 144
SP - 109
EP - 115
JO - Journal of Cancer Research and Clinical Oncology
JF - Journal of Cancer Research and Clinical Oncology
SN - 0171-5216
IS - 1
ER -