Newlands E S, Holden L, Bagshawe K D
Department of Medical Oncology, Charing Cross Hospital, London, U.K.
Int J Biol Markers. 1988 Jul-Sep;3(3):185-92. doi: 10.1177/172460088800300307.
The management of ovarian germ cell tumours (GCTs) has changed dramatically over the last 15 years. The combination of the introduction of tumour markers which accurately monitor the behaviour of the majority of germ cell tumours together with the introduction of newer chemotherapeutic agents has meant that few patients even with metastases should succumb from their disease. The tumour markers, human chorionic gonadotrophin (hCG) and alpha-foetoprotein (AFP) and, to a lesser extent, lactate dehydrogenase (LDH) and placental alkaline phosphatase (PLAP) are routinely used in assisting diagnosis, monitoring response to treatment and increasing the sensitivity of follow-up of patients after completing treatment. Analysis of our last 51 patients with all cell types of ovarian germ cell tumour has confirmed the importance of both hCG and AFP in that 45 (88%) of 51 patients had either or both of these tumour markers raised at the start of treatment for metastatic disease. Our data on LDH is incomplete since this has not been a routine assay until 1984 and, of the patients with active disease 10 (48%) had raised LDH at the start of treatment. PLAP has also been measured in a number of patients both on active treatment and in remission. 11 (50%) had raised levels of PLAP at the start of treatment but there was also a false positive rate of 8 (24%) of the 33 patients who were in remission and had not subsequently relapsed.
在过去15年中，卵巢生殖细胞肿瘤（GCTs）的治疗发生了巨大变化。准确监测大多数生殖细胞肿瘤行为的肿瘤标志物的引入，以及新型化疗药物的引入，这两者相结合意味着即使是有转移的患者，也很少会死于该疾病。肿瘤标志物，即人绒毛膜促性腺激素（hCG）和甲胎蛋白（AFP），以及在较小程度上的乳酸脱氢酶（LDH）和胎盘碱性磷酸酶（PLAP），在辅助诊断、监测治疗反应以及提高完成治疗后患者随访的敏感性方面被常规使用。对我们最近51例所有细胞类型的卵巢生殖细胞肿瘤患者的分析证实了hCG和AFP两者的重要性，因为在51例患者中，有45例（88%）在转移性疾病治疗开始时出现了这两种肿瘤标志物中的一种或两种升高。我们关于LDH的数据不完整，因为直到1984年它才成为一项常规检测，并且在患有活动性疾病的患者中，有10例（48%）在治疗开始时LDH升高。在许多接受积极治疗和处于缓解期的患者中也检测了PLAP。11例（50%）在治疗开始时PLAP水平升高，但在33例处于缓解期且随后未复发的患者中，也有8例（24%）出现假阳性率。
