Improved Human Chorionic Gonadotropin Detection With Carboxyl-Terminal Radioimmunoassay of the Beta Subunit on Concentrated 24-Hour Urine in Patients With Testicular Cancer

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Abstract
The value of measuring serum levels of human chorionic gonadotropin [HCG] in detecting and monitoring testicular cancer has been demonstrated convincingly. The HCG was extracted by the kaolin-acetone procedure from 24-h urine specimens; the total volume of the extract was adjusted to 15 ml. With a highly specific immunoassay system (H93) that recognizes the unique carboxyl-terminal peptide of HCG .beta.-subunit (residue numbers 123 to 145) as described previously, the urinary HCG was measured serially in 32 specimens of 15 patients with initially HCG-producing testicular tumors. These 15 patients had simultaneous measurements of serum HCG using an antiserum against the .beta.-subunit (Sb6) and urinary HCG concentrates using H93 radioimmunoassay. The initial serum hormone levels of these 15 patients were elevated and returned to normal after therapy. Despite this occurrence the urinary hormone levels also were elevated. The initial 5 patients with elevated urinary but normal serum HCG levels had recurrence. The use of this highly specific radioimmunoassay in measuring urinary HCG coupled with effective chemotherapeutic agents was valuable in selecting patients in whom further therapy is warranted despite normal serum HCG and clinically undetectable tumor.