Richardson R L, Schoumacher R A, Fer M F, Hande K R, Forbes J T, Oldham R K, Greco F A
Ann Intern Med. 1981 Feb;94(2):181-6. doi: 10.7326/0003-4819-94-2-181.
Within 3 years we saw 12 patients diagnosed initially as having poorly differentiated or undifferentiated carcinomas who, we believe, actually had extragonadal germinal cancers. Serum levels of the beta subunit of human chorionic gonadotropin (beta-HCG) or alpha-fetoprotein were useful in suggesting and supporting the diagnosis: Levels of one or the other were elevated in six of 10 patients in whom they were measured but levels of both, in only one patient. Staining of histologic specimens for beta-HCG or alpha-fetoprotein showed intracellular localization of one of these markers in the cancer cells of all four patients studied. All patients responded to therapy (11 treated with chemotherapy with or without radiotherapy, one with excision and radiotherapy only), with complete remissions in seven of 12. Two of the patients who had a complete remission have experienced relapse, and five have continued in disease-free remission from more than 8 to more than 56 months. Histologically atypical extragonadal germ cell neoplasms may be commoner than previously supposed. Physicians should consider this treatable and potentially curable cancer in selected patients having poorly differentiated or undifferentiated carcinomas.
在3年时间里，我们见到了12例最初被诊断为低分化或未分化癌的患者，我们认为他们实际上患的是性腺外生殖细胞癌。血清人绒毛膜促性腺激素β亚基（β-HCG）或甲胎蛋白水平有助于提示和支持诊断：在检测这两种指标的10例患者中，有6例其中一项指标升高，而两项指标都升高的仅1例。对组织学标本进行β-HCG或甲胎蛋白染色显示，在所有4例接受研究的患者的癌细胞中，这两种标志物之一呈细胞内定位。所有患者对治疗均有反应（11例接受了化疗，联合或不联合放疗，1例仅接受了切除和放疗），12例中有7例完全缓解。2例完全缓解的患者出现了复发，5例持续无病缓解超过8至56个月。组织学上非典型的性腺外生殖细胞肿瘤可能比以前认为的更为常见。对于患有低分化或未分化癌的特定患者，医生应考虑到这种可治疗且可能治愈的癌症。
