Importance of the detection method for intact dimeric human chorionic gonadotropin without interference with the free human chorionic gonadotropin β subunit for pregnancy exclusion before liver transplantation in a woman with cholangiocarcinoma
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Catherine Massart
Abstract
Assay of human chorionic gonadotropin (hCG) is mainly used for the detection and monitoring of pregnancy, and for the follow-up of trophoblastic tumors. The serum free β-hCG subunit (hCGβ) is also a tumor marker in many non-trophoblastic tumors, including gastrointestinal cancers. In this work, we compared the performance of several immunoassays for pregnancy exclusion before liver transplantation and in the follow-up of a woman with cholangiocarcinoma. Serum hCG was detected with the Abbott Testpack plus hCG-Combo and measured with four automated sandwich immunoassays: ADVIA-Centaur, ACS:180, AxSYM and Dimension. hCGβ was determined by an automated fluorescence sandwich immunoassay (Kryptor-Free β hCG) and with a specific immunoradiometric assay (ELSA-F β hCG, Schering). The expression of hCG was also evaluated by immunohistochemistry on sections of intrahepatic cholangiocarcinoma cells and on peritoneal metastases. Before transplantation, discordant results were observed for pregnancy exclusion. Qualitative Testpack and Dimension tests detected no hCG-like immunoreactivity, whereas the ADVIA-Centaur, ACS:180 and AxSYM tests revealed positive levels. The same discrepancy was obtained in follow-up of the patient after liver transplantation. hCGβ assay and immunohistochemical staining revealed tumor cell secretion of hCGβ. In conclusion, a specific serum immunoassay for intact dimeric hCG without cross-reaction with hCGβ should be adopted as routine policy for pregnancy exclusion before liver transplantation.
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©2005 by Walter de Gruyter Berlin New York
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- High-throughput scanning of breast tumor surgical specimens for low-level mutations
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- Soluble CD30 serum levels before and after treatment with α-interferon in patients with chronic hepatitis C
- Development, validation and evaluation of a homogenous one-step reverse transcriptase-initiated PCR assay with competitive internal control for the detection of hepatitis C virus RNA
- Counteracting adriamycin-induced oxidative stress by administration of N-acetyl cysteine and vitamin E
- Comparative analysis of the DNA staining efficiencies of different fluorescent dyes in preparative agarose gel electrophoresis
- Thyroglobulin assay 4 weeks after thyroidectomy predicts outcome in low-risk papillary thyroid carcinoma
- Measurement of troponin I 48h after admission as a tool to rule out impaired left ventricular function in patients with a first myocardial infarction
- The efficacy of cystatin C assay in the prediction of glomerular filtration rate. Is it a more reliable marker for renal failure?
- Reference materials (RMs) for analysis of the human factor II (prothrombin) gene G20210A mutation
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