Mohler J L, Siami P F, Flanigan R C
Urology. 1987 Sep;30(3):252-4. doi: 10.1016/0090-4295(87)90247-0.
Persistent elevations in serum markers after chemotherapy for germ cell testicular carcinoma indicate residual disease. We report on a patient with advanced seminoma with choriocarcinoma who had elevated serum beta-human chorionic gonadotropin (beta-HCG) and residual masses on computerized tomography scan after chemotherapy. Wedge liver resection and retroperitoneal node dissection yielded only necrotic tissue which assayed and immunoperoxidase stained positively for beta-HCG. Serum beta-HCG fell to undetectable levels postoperatively, and the patient remains disease-free after three years. Phagocytosis of necrotic tumor apparently released entrapped beta-HCG resulting in a false positive tumor marker.
睾丸生殖细胞癌化疗后血清标志物持续升高提示存在残留病灶。我们报告了一名患有晚期精原细胞瘤合并绒毛膜癌的患者,其化疗后血清β-人绒毛膜促性腺激素(β-HCG)升高,计算机断层扫描显示有残留肿块。肝楔形切除术和腹膜后淋巴结清扫术仅获得坏死组织,该组织经检测及免疫过氧化物酶染色β-HCG呈阳性。术后血清β-HCG降至无法检测的水平,患者三年后仍无疾病复发。坏死肿瘤的吞噬作用显然释放了被困的β-HCG,导致肿瘤标志物出现假阳性。