Human Chorionic Gonadotropin (hCG) Testing in Specimens of Tumor and Myometrial Tissues During Surgical Treatment of Gestational Trophoblastic Tumors

Abstract

Background: Gestational trophoblastic tumors originate from trophoblastic tissues and secrete human chorionic gonadotrophin (hCG). Surgical treatment may be a line of treatment of chemoresistant cases. Objective: To evaluate the accuracy of hCG dipsticks in detection of hCG in tissues of trophoblastic tumors and healthy myometrium during surgery of trophoblastic tumors. Methods: We included 19 samples of tumor and apparently healthy myometrial tissues during surgical treatment of 5 cases of gestational trophoblastic tumors. The hCG dipstick was immersed in a solution containing 1x1 cm of tumor or myometrial tissues. The results of the tests were compared to the histopathological results. Results: The mean age of patients were 38.8 years, the mean parity was 3.4. The mean serum B-hCG level was 101,745.6 mu/ml. Except for one specimen in case 5, all results of the hCG dipsticks were concordant with final histopathologic analysis of the specimens. Sensitivity of hCG test was 100% and specificity was 90%. Conclusion: Intraoperative detection of hCG in different tissues and suspicious masses can be considered as simple, rapid, inexpensive, and reliable test. It can be used to detect the trophoblastic nature of tissues if frozen section is not available as some low resource setting countries. We recommend further larger prospective studies to compare the accuracy and reliability of this novel technique and frozen section analysis.