Bosl G J, Lange P H, Fraley E E, Goldman A, Nochomovitz L E, Rosai J, Waldmann T A, Johnson K, Kennedy B J
Cancer. 1981 Jan 15;47(2):328-32. doi: 10.1002/1097-0142(19810115)47:2<328::aid-cncr2820470220>3.0.co;2-z.
Thirty patients with nonseminomatous testicular cancer and no evidence of metastases outside the retroperitoneum were evaluated for discrepancy between the clinical and pathologic stages and also for frequency of elevations of the serum levels of human chorionic gonadotropin (hCG) and alphafetoprotein (AFP). When marker-level data were not considered in the staging, the clinical and pathologic stages differed in 47% of the patients; the inclusion of marker data reduced the staging error to 37%. Seven of ten patients with clinical Stage I, pathologic Stage II disease had normal marker levels (false-negative results). However, there were no false-positive results: abnormal marker levels before retroperitoneal lymphadenectomy always signalled persistent tumor unless the level could be accounted for by the metabolic decay rate of marker produced by the primary tumor. Comparison of marker-level data from these patients with data from 48 patients with Stage III disease demonstrated increasing frequency of elevated marker levels with increasing stage (P less than 0.001). Serial determinations of HCG and AFP are helpful in clinical staging and are necessary in clinical management.
对30例非精原细胞瘤性睾丸癌患者进行评估，这些患者腹膜后以外无转移证据，评估临床分期与病理分期之间的差异以及血清人绒毛膜促性腺激素（hCG）和甲胎蛋白（AFP）水平升高的频率。在分期时若不考虑标志物水平数据，47%的患者临床分期与病理分期不同；纳入标志物数据后分期误差降至37%。临床I期、病理II期的10例患者中有7例标志物水平正常（假阴性结果）。然而，无假阳性结果：腹膜后淋巴结清扫术前标志物水平异常总是提示肿瘤持续存在，除非该水平可由原发肿瘤产生的标志物代谢衰减率来解释。将这些患者的标志物水平数据与48例III期疾病患者的数据进行比较，结果显示随着分期增加，标志物水平升高的频率增加（P<0.001）。连续测定hCG和AFP有助于临床分期，在临床管理中是必要的。
