Motawy M S, Szymendera J J, al-Jazzaf H, Behbehani A E, Foudeh M O, Ebraheem A K, Nasralla M Y, Ali M A
Department of Medical Oncology, Kuwait Cancer Control Center, Shuwaikh.
Int J Biol Markers. 1992 Apr-Jun;7(2):80-6. doi: 10.1177/172460089200700202.
Serum levels of AFP, hCG and CEA were initially and serially measured in 59 patients with testicular germ cell tumors, and serially in 37 with ovarian and 3 with extragonadal germ cell tumors. Patients with seminoma/dysgerminoma or mature teratoma had normal serum AFP and sporadically slightly elevated hCG. Some patients with embryonal carcinoma, pure or with admixture of seminoma, had serum AFP elevated to maximum 100 U/ml, yet its use for monitoring therapy was limited. Patients with yolk sac tumors had elevated AFP and sometimes CEA levels, those with choriocarcinoma had elevated hCG, and those with compound tumors had one or more of the markers highly elevated. High AFP and/or hCG levels indicated the presence of the relevant tumor cells both in the primary and in residual tumor and/or metastases, also those missed in histological material, and thus were useful in restaging. Unfortunately, their absence in serum did not exclude the presence of marker-negative subpopulations of tumor cells. Changes in marker values paralleled the effects of treatment: the level increasing from any nadir heralded recurrence in patients in remission; elevated or increasing levels during therapy implied resistance to the therapy; decreasing levels indicated regression even though a return to the normal range did not mean eradication of all tumor cells.
对59例睾丸生殖细胞肿瘤患者以及37例卵巢生殖细胞肿瘤患者和3例性腺外生殖细胞肿瘤患者，最初并连续检测其血清甲胎蛋白（AFP）、人绒毛膜促性腺激素（hCG）和癌胚抗原（CEA）水平。精原细胞瘤/无性细胞瘤或成熟畸胎瘤患者的血清AFP正常，hCG偶尔略有升高。一些胚胎癌患者，无论是单纯胚胎癌还是合并精原细胞瘤，其血清AFP升高至最高100 U/ml，但用于监测治疗的价值有限。卵黄囊瘤患者的AFP升高，有时CEA水平也升高；绒毛膜癌患者的hCG升高；混合性肿瘤患者的一种或多种标志物高度升高。高AFP和/或hCG水平表明原发肿瘤、残留肿瘤和/或转移灶中存在相关肿瘤细胞，包括组织学检查未发现的肿瘤细胞，因此有助于重新分期。遗憾的是，血清中这些标志物的缺失并不能排除存在标志物阴性的肿瘤细胞亚群。标志物值的变化与治疗效果平行：处于缓解期的患者，任何最低点后标志物水平升高预示复发；治疗期间标志物水平升高或持续升高意味着对治疗耐药；标志物水平下降表明肿瘤退缩，尽管恢复到正常范围并不意味着所有肿瘤细胞都已被清除。
