Bonazzi C, Colombo N, Lissoni A, Pittelli M R, Bini S, Mangioni C
J Nucl Med Allied Sci. 1989 Jul-Sep;33(3 Suppl):53-8.
From 1982 to 1989 positive alpha-fetoprotein (AFP) levels were detected after surgery in 3 patients with pure immature teratoma, 7 patients with mixed germ cell tumors and 16 patients with pure endodermal sinus tumor (EST) of the ovary. In the three patients with pure immature teratoma, AFP serum levels became spontaneously undetectable in one month without chemotherapy. The marker was thereafter negative, despite the persistence of tumor in 2 patients, and a relapse in the third one. The serum levels of AFP did not correlate with the stage of EST and mixed germ cell tumors. The monitoring of AFP serum levels during treatment correlated with response to chemotherapy: of the 16 patients with pure EST, 14 achieved a serological complete response and did not undergo second look surgery; two patients had a serological partial response. One of them reached a serological complete response after further chemotherapy. The other patient with liver extragonadic tumor underwent liver lobectomy with negative histology. Among 7 patients with mixed germ cell tumor, 6 achieved a serological and pathologic complete response. The 7th patient had a serological complete response, but microscopic residual tumor at second look laparotomy. The decrement curve of AFP was not predictive for recurrence. However, AFP monitoring was useful for an early diagnosis of relapse in 4 patients. AFP is a reliable marker for the diagnosis, treatment evaluation and follow-up of patients with pure EST and a useful marker in the clinical management of mixed germ cell tumors of the ovary.
1982年至1989年期间，对3例卵巢纯未成熟畸胎瘤患者、7例混合性生殖细胞肿瘤患者和16例纯内胚窦瘤（EST）患者术后检测到甲胎蛋白（AFP）水平呈阳性。在3例纯未成熟畸胎瘤患者中，1例未经化疗在1个月内AFP血清水平自发检测不到。此后，尽管2例患者肿瘤持续存在，第3例患者复发，但该标志物一直呈阴性。AFP血清水平与EST和混合性生殖细胞肿瘤的分期无关。治疗期间监测AFP血清水平与化疗反应相关：16例纯EST患者中，14例血清学完全缓解，未进行二次探查手术；2例患者血清学部分缓解。其中1例患者在进一步化疗后达到血清学完全缓解。另1例伴有肝外性腺肿瘤的患者接受了肝叶切除术，组织学检查为阴性。7例混合性生殖细胞肿瘤患者中，6例血清学和病理学完全缓解。第7例患者血清学完全缓解，但二次剖腹探查时发现微小残留肿瘤。AFP的下降曲线不能预测复发。然而，AFP监测对4例患者的复发早期诊断有用。AFP是纯EST患者诊断、治疗评估和随访的可靠标志物，也是卵巢混合性生殖细胞肿瘤临床管理中的有用标志物。
