Value of beta-HCG in clinicopathological diagnosis of intracranial germ cell tumors

LIU Juan; LU Zhao-hui

doi:10.3969/j.issn.1007-8096.2018.06.005

Abstract：Objective To explore the relationship between immunophenotype, pathological features and clinical phenotype of intracranial germinoma. Methods The histological and immunohistochemical features of 50 cases of intracranial germ cell tumors were retrospectively analyzed. The clinical manifestations, serology and cerebrospinal fluid examination results were statistically analyzed. Results In 50 cases, 6 cases were combined with other tumor components (12％), including 4 cases with trophoblastic components, 1 cases with teratomas with malignant transformation and 1 cases with mature teratoma, in which human chorionic gonadotropin (beta-HCG) immunohistochemical staining was strongly positive (positive rate 100％) in all the cases. CSF beta-HCG values were greater than 5 IU/1 (8.4 ～439 IU/1, average 163.23 + 179.14 IU/1), 4.5 ～798 IU/1 beta-HCG value in the blood, an average of 173.37 +311.44 IU/1, more than 5 IU/1 in 5 cases. Beta-HCG in cerebrospinal fluid was greater than or equal to 5 IU/1 in 33 of 44 cases of germ cell tumor (33/44, 75％ ); 9 cases of 5 IU/1 beta value was more than HCG in the blood (9/44, 20.45％ ); In 24 cases that were studied by immunohistochemical staining of beta-HCG, 7 were positive (7/24, 29.17％). There was a significant correlation between the histological beta-HCG positive and preoperative blood beta-HCG value (P > 0.01), but no correlation with the preoperative cerebrospinal fluid beta-HCG value was noted (P > 0.05). Conclusion Intracranial germ cell tumors present more commonly with simple component. If not single, the combination is commonly seen with germ cell tumor with positive beta-HCG; cerebrospinal fluid beta-HCG greater than 5 IU/1 has the sensitivity in the diagnosis, while beta-HCG in both blood and tissue has higher specificity.