Diagnostic value of serum levels of β-human chorionic gonadotropin (β-hcG) combined with β-hcG in cerebrospinal fluid for determining locations of germinomas in children with precocious puberty / 中华儿科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical manifestations of germinoma in children with precocious puberty and to evaluate the diagnostic value of serum levels of β-human chorionic gonadotropin (β-hcG) combined with detections of β-hcG in cerebrospinal fluid (CSF).</p><p><b>METHOD</b>Twelve male children with germinomas confirmed by pathology from Jan. 2005 to Dec. 2009, aged from 4.2 to 10.2 years, were enrolled in this study. Patients were classified into two groups according to tumor locations intracranial group and non-intracranial group. Levels of β-hcG in serum as well as in CSF were detected before the initiation of therapy. Age and gender matched 5 children undergoing lumbar puncture for other diseases were set as control group for the determinations of β-hcG in CSF. Levels of β-hcG and testosterone in serum and CSF were compared between intracranial group and non-intracranial group, and levels of β-hcG in CSF were compared between non-intracranial group and control group.</p><p><b>RESULT</b>The 12 children showed elevated serum levels of testosterone 10.43 (1.70-254.00) µg/L, 11 children had testicular volume > 4 ml, while response to LHRH stimulation tests were low; 6 children had gynecomastia. Serum levels of β-hcG were elevated in both intracranial and non-intracranial group and no significant differences were found between groups 63.75 (8.50-309.50) IU/L vs. 59.00 (25.10-71.77) IU/L, P = 0.644. No correlations were found between serum levels of β-hcG and ages, tumor locations, and courses of the patients. Levels of β-hcG in CSF were significantly higher in intracranial group than that in non-intracranial group 488.99 (17.30-1048.53) IU/L vs. 1.20 (1.20-1.50) IU/L, P = 0.009. Children with non-intracranial germinomas had similar levels of β-hcG in CSF as that in control group (P = 0.571).</p><p><b>CONCLUSION</b>The main clinical manifestations in boys suffered from germinoma included pseudo-precocious puberty, disproportionate testicular volume and gynecomastia. Detection of serum levels of β-hcG combined with β-hcG levels in CSF may be useful for determination of the locations of germinomas in children with precocious puberty.</p>