Funahashi Makoto, Tuchiya Futoshi, Makiyama Kazuhide, Sugiura Shinpei, Miyoshi Yasuhide, Kishida Takeshi, Ogawa Takehiko, Uemura Hiroji, Yao Masahiro, Kubota Yoshinobu
Department of Urology, Yokohama City University School of Medicine.
Hinyokika Kiyo. 2005 Feb;51(2):133-7.
Two patients with testicular tumors whose serum alpha-fetoprotein (AFP) persisted to show an abnormally high concentration are reported. Case 1 : A 42-year-old male who had been suffering from chronic hepatitis, underwent left high orchiectomy for a left testicular tumor in 1998. Diagnosis was an authentic stage I seminoma. In 2002, chemotherapy was performed for a metastatic seminoma revealed as a solitary mass in the mediastinum by radiographic studies, and histologically confirmed to be a metastatic seminoma. Although lymph nodes were gradually reduced in size, the serum AFP and transaminase levels remained at an abnormally high concentration. The subfraction profile with lens culinaris hemagglutinin (LCA) revealed elevation of only peak 1 which implied that the chronic hepatitis was due to liver dysfunction. After a 10-month follow-up the levels of both AFP and transaminase decreased, and the patient was disease-free. Case 2: In 2002, a 30-year-old male underwent left high orchiectomy for a left testicular tumor, and histological examination revealed seminoma, immature and mature teratoma, embryonal carcinoma. The serum AFP was elevated to 45 ng/ml. Diagnosis was authentic stage I. After 2 courses of chemotherapy, the serum AFP remained at an abnormally high concentration. However, there were no new lesions. The serum AFP level was not elevated in any of the family members. The subfraction profile with LCA revealed elevation of only peak 1, which implied that there were no viable lesions. After a 24-month follow-up AFP was about 20 ng/ml and the patient was disease-free.
报告了两名睾丸肿瘤患者，其血清甲胎蛋白（AFP）持续显示异常高浓度。病例1：一名42岁男性，患有慢性肝炎，1998年因左侧睾丸肿瘤接受左侧高位睾丸切除术。诊断为真正的I期精原细胞瘤。2002年，对通过影像学检查发现纵隔有一个孤立肿块并经组织学证实为转移性精原细胞瘤进行化疗。尽管淋巴结大小逐渐缩小，但血清AFP和转氨酶水平仍维持在异常高浓度。用刀豆球蛋白A（LCA）进行的亚组分分析显示只有峰1升高，这表明慢性肝炎是由于肝功能障碍所致。经过10个月的随访，AFP和转氨酶水平均下降，患者无疾病。病例2：2002年，一名30岁男性因左侧睾丸肿瘤接受左侧高位睾丸切除术，组织学检查显示为精原细胞瘤、未成熟和成熟畸胎瘤、胚胎癌。血清AFP升高至45 ng/ml。诊断为真正的I期。经过2个疗程的化疗后，血清AFP仍维持在异常高浓度。然而，没有新的病变。任何家庭成员的血清AFP水平均未升高。用LCA进行的亚组分分析显示只有峰1升高，这表明没有存活的病变。经过24个月的随访，AFP约为20 ng/ml，患者无疾病。
