This site is intended for healthcare professionals

Sign in
Go to /sign-in page

You can view 5 more pages before signing in

HCG in testicular cancer

Authoring team

Human chorionic gonadotrophin (HCG) is a glycoprotein produced by the placenta to maintain the corpus luteum during pregnancy. HCG can be elevated in a number of other malignancies, including cancers of the liver, lung, pancreas and stomach.

In germ cell tumours of the testis, including both seminomas and nonseminomatous germ cell tumours (NSGCT), cancerous cells can transform into syncytiotrophoblasts (a normal component of the placenta) and secrete HCG. (1,2)

Levels greater than 5,000 IU are usually indicative of NSGCT, and in NSGCT, higher levels of HCG are associated with a worse prognosis. However, HCG-producing seminoma (approximately 15 percent of seminomas) has the same prognosis as seminoma that does not produce HCG.


The HCG molecule is cross-reactive with another protein, luteinizing hormone (LH). Hypogonadal men can have elevated LH levels and subsequently falsely elevated HCG levels — administration of exogenous testosterone can help distinguish HCG elevation from hypogonadism from HCG from testis cancer. In addition, marijuana smoking has been associated with an elevated HCG level.

  • very high serum HCG concentrations occur in hydatidiform moles ("molar" pregnancies) and choriocarcinomas (97%)
  • for tumour marker use, measurement of both intact HCG and its free beta subunit (beta HCG) is highly desirable, as some tumours may produce only beta HCG
  • increased serum HCG concentrations occur in both seminoma and NSGCT, with a diagnostic sensitivity of 40-60% in patients with metastatic NSGCT and 15-20% in those with metastatic seminoma. HCG elevations are predominantly found in patients with tumours containing choriocarcinomatous components, syncytiotrophoblastic giant cells and (more rarely) special round cells also found in pure seminomas.
  • the normal range is less than 5 IU/L, with a half life of 24 to 36 hours

Reference:

  1. Stephenson A et al. Diagnosis and Treatment of Early Stage Testicular Cancer: AUA Guideline. J Urol. 2019 Aug;202(2):272-281
  2. Milose JC, Filson CP, Weizer AZ, Hafez KS, Montgomery JS. Role of biochemical markers in testicular cancer: diagnosis, staging, and surveillance. Open Access J Urol. 2011 Dec 30;4:1-8

Related pages

Create an account to add page annotations

Create a free account

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page