Background: Beta (β)-human chorionic gonadotropin (β-HCG) is used to confirm the diagnosis and plan treatment of intracranial germinomas. However, the cutoff values of serum β-HCG in diagnosis of intracranial germinomas reported in the literature are inconsistent. To establish an appropriate cutoff value of serum β-HCG for diagnosis of intracranial germinomas, we retrospectively reviewed the records of intracranial tumor patients who received serum β-HCG and α-fetoprotein (AFP) tests for diagnostic purposes at our hospital from 2005 to 2014. Methods: A total of 93 intracranial germinomas and 289 intracranial non-germ cell tumors were included in this study. Receiver operating characteristic (ROC) analysis was used to evaluate the sensitivity and specificity of 3 cutoffs (0.1, 0.4, and 0.5 mIU/mL) for diagnosing intracranial germinomas. The serum β-HCG level of intracranial germinoma patients was further analyzed to investigate the effect of metastasis status and tumor location on serum β-HCG level. Results: The area under the ROC curve was 0.81 (P <.001), suggesting β-HCG is an effective marker. Of the 3 cutoff values, 0.1 mIU/mL possessed a highest sensitivity (66.67%) and good specificity (91%). Although there was no β-HCG level difference between metastatic and non-metastatic intracranial germinoma patients, the diagnostic rate of metastatic neurohypophyseal germinomas was significantly higher than that of its non-metastatic counterpart (P <.05), implying that the location of the germinoma might need to be considered when β-HCG is used as a marker to predict metastasis. Conclusions: Determining an optimal cutoff of serum β-HCG is helpful for assisting the diagnosis of intra-cranial germinoma.
Zhang, H., Zhang, P., Fan, J., Qiu, B., Pan, J., Zhang, X., … Qi, S. (2016). Determining an optimal cutoff of serum β-human chorionic gonadotropin for assisting the diagnosis of intracranial germinomas. PLoS ONE, 11(1). https://doi.org/10.1371/journal.pone.0147023