Suzuki K, Tokue A
Department of Urology, Jichi Medical School.
Hinyokika Kiyo. 2001 Jul;47(7):467-72.
This study was designed to examine whether measurement of serum CA19-9 was useful in testicular germ cell tumor patients. We analyzed the clinical courses of 55 testicular germ cell tumor cases diagnosed after high orchiectomy. The patients in this study consisted of 33 seminomas and 22 non-seminomatous germ cell tumors (NSGCT), and their mean age was 32.7 +/- 12.7 years (mean +/- SD). The mean follow-up period after the operation was 33.7 months. The positive rate of the pre-treatment serum CA19-9 level was 16.4% (3.0% in seminomas versus 36.4% in NSGCT, p = 0.0017). The pre-treatment serum CA19-9 levels in NSGCT patients were significantly higher than those in seminoma patients (46.6 +/- 50.0 U/ml versus 10.6 +/- 9.6 U/ml, p = 0.0008). We divided the patients into two groups according to the detailed histological types, and found that the serum CA19-9 levels in the patients with embryonal carcinoma (EC) were significantly higher than in those without EC (p = 0.0160), and the levels in those with yolk sac tumor (YS) were higher than in those without YS (p = 0.0099). Moreover, the levels in those with either EC or YS were significantly higher than in those with neither EC nor YS (p = 0.0004). In 9 patients with a high serum pre-treatment CA19-9 level, the serum CA19-9 level was useful as a monitoring marker through the treatment or tumor progression. On the other hand, the pre-treatment serum CA19-9 level did not correlate with the clinical stage or prognosis. In conclusion, the phenomenon that the serum levels of CA19-9 increase in testicular germ cell tumor patients is not extremely rare, and in NSGCT, especially in EC or YS, the serum CA19-9 can be a useful tumor marker.
本研究旨在探讨血清CA19-9检测对睾丸生殖细胞肿瘤患者是否有用。我们分析了55例经高位睾丸切除术后诊断为睾丸生殖细胞肿瘤患者的临床病程。本研究中的患者包括33例精原细胞瘤和22例非精原生殖细胞肿瘤（NSGCT），他们的平均年龄为32.7±12.7岁（平均±标准差）。术后平均随访期为33.7个月。治疗前血清CA19-9水平的阳性率为16.4%（精原细胞瘤中为3.0%，NSGCT中为36.4%，p = 0.0017）。NSGCT患者治疗前血清CA19-9水平显著高于精原细胞瘤患者（46.6±50.0 U/ml对10.6±9.6 U/ml，p = 0.0008）。我们根据详细的组织学类型将患者分为两组，发现胚胎癌（EC）患者的血清CA19-9水平显著高于无EC患者（p = 0.0160），卵黄囊瘤（YS）患者的血清CA19-9水平高于无YS患者（p = 0.0099）。此外，有EC或YS患者的血清CA19-9水平显著高于既无EC也无YS患者（p = 0.0004）。在9例治疗前血清CA19-9水平较高的患者中，血清CA19-9水平可作为治疗或肿瘤进展的监测指标。另一方面，治疗前血清CA19-9水平与临床分期或预后无关。总之，睾丸生殖细胞肿瘤患者血清CA19-9水平升高的现象并不十分罕见，在NSGCT中，尤其是在EC或YS中，血清CA19-9可能是一种有用的肿瘤标志物。
