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Human chorionic gonadotrophin (hCG) (tumour marker)

Test Background

hCG is a sialoglycoprotein hormone with a molecular weight of about 36.5 kDa. hCG, together with LH, FSH and TSH, forms the glycoprotein hormone family, all of which are heterodimers that share a common 92 amino acid α­-subunit. The distinct β-subunit confers biological activity and only the intact αβ-heterodimer of hCG can stimulate sex steroid production through the LH/hCG G-protein-coupled receptor. hCG is secreted by the trophoblastic placental cells and a variety of tumours.

However, tiny amounts are also produced by the pituitary. hCG exists not only as the intact heterodimer but also as free subunits and an array of molecular variants that are recognised by different hCG assays to a variable degree. The hCG tumour marker assay we provide is a ‘total’ hCG assay that recognises all forms for which WHO protein standards have been formulated, and is used for the management of germ cell tumour (GCT) and gestational trophoblastic disease (GTD).

Clinical Indications

Diagnosis: hCG measurement is used in the diagnosis of GTD and GCT. hCG measurement is the basis of post-molar screening for gestational trophoblastic neoplasia (GTN). CSF measurement is helpful in diagnosis of primary intracranial GCT and detecting metastatic spread to the brain in GTN.
Prognosis and staging: hCG is used for risk stratification and treatment decision making in GTN and GCT.
Treatment monitoring: response to treatment in GTN and GTD is monitored using 1-2 weekly hCG measurements.
Surveillance: in GCT, serial monitoring with hCG (and AFP) at decreasing frequency for a minimum of 10 years is used in both marker positive and negative disease.
Following treatment for GTN, hCG is monitored for life.

Reference Range

Serum (non-pregnant): <5 IU/L

Urine (random, non-pregnant): <25 IU/L

CSF: <2 IU/L

Sample volume
For CSF analysis: 1.0 mL. For urine: 0.5 mL. For serum: 0.5mL.
Turnaround time
4 days
Sample & Container Required
SST (gold top) preferred, serum (red top) accepted, random urine accepted.
Sample Container
For CSF analysis: Universal container
Sample Collection

SST (gold top) preferred, serum (red top) accepted

For CSF analysis: Samples should be as fresh as possible. Avoid repeated freeze/thaw cycles.

Transport Storage
Store at 2-8°C and send by first class post.
Notes

In-house radioimmunoassay.

Record last updated
August 21, 2025

Sample Container

5ml SST Vacutainers (Gold / Yellow top)

Sample Container

6ml Plain Vacutainers (Red top)

Sample Container

150ml Universal Container for Urine TB (Silver top)

Sample Container

60ml Universal container - Sputum and Fluids (White top)

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Test Results

Yes, we have a Pathology User Guide

Yes. Please email your request to Imperial.nwlpcustomerservice@nhs.net

Results are communicated to clinical staff and are normally not communicated direct to patients either on telephone requests or in written report. If you need to contact us please click here to view the contact details page

Please contact the Customer Service Team Monday to Friday from 8:30am – 6:00pm on 0203 313 5353. Alternatively, see the Pathology User Guide for how to contact the relevant department. If advice is not urgent you can also email your query to Imperial.nwlpcustomerservice@nhs.net

Additional tests may be added by discussion with the relevant laboratory. The time limit for adding additional tests to a sample already received in the laboratory will depend on the type of sample and the department it was sent to.

Information on the repertoire of tests performed by pathology, including reference ranges, turnaround times and specimen requirements, can be found in the test directory.

Different tests have different sample stability requirements. If a comment on results indicates that the sample was delayed, the links below will indicate which tests may have been affected. This information is for serum or plasma samples.

For some tests, the impact of delay is consistent and these are marked with an arrow:

↑ indicates tests where delayed centrifugation results in falsely elevated results and the true level is likely lower than that reported.

↓ indicates tests where delayed centrifugation results in falsely lowered results and the true level is likely higher than that reported.

If there is no arrow, the true level may be lower or higher than reported.

Please interpret results with caution and consider the impact of any uncertainty.

The comment on the report will state how delayed the sample was. Please click the relevant link  below to see which other tests may have been affected.

>8h >12h >24h >48h >72h

NWLP operates UKAS accredited medical laboratories as per the references below. The current scope of accreditation for all NWLP’s laboratories can be found on the UKAS website.

UKAS accredited medical laboratory/medical diagnostic service:

  • Clinical Biochemistry No. 8673
  • Haematology and Blood Transfusion No. 8674
  • Infection & Immunity Sciences (Including Immunology, Virology, Microbiology and Histocompatibility and Immunogenetics ) No. 8659
  • Cellular Pathology (Including Histopathology, Cytology and Molecular Pathology) No. 9615

If you require copies of our certificate of accreditation and associated documentation please contact Imperial.nwlpcustomerservice@nhs.net.

UKAS requires the laboratories to be accredited for a particular repertoire/scope (ISO15189), any changes or additions to repertoire require assessment by UKAS (extension to scope).

The BD Hospital Tube GuideBD GP Tube Guide and BD Paediatric Tube Guide provide visual references to the correct tube types and collection instructions.

Home testing

INSTRUCTION SHEET FOR BLOOD SAMPLE COLLECTION 

We also have two instruction videos available (one with subtitles and one without) – please click on the links to view the videos on Google.

VIDEO ON BLOOD SAMPLE COLLECTION (without subtitles)

VIDEO ON BLOOD SAMPLE COLLECTION (with subtitles)

Our accreditations

Upholding excellence in diagnostic standards

Our laboratories are accredited by the UK Accreditation Service (UKAS) against the international standard ISO15189:2022. UKAS is the accreditation body for the UK that assesses medical laboratories.

Find out more about our accreditations on the UKAS website.

UKAS website
Man in the lab handling a sample