Jacobsen G K, Nørgaard-Pedersen B
Acta Pathol Microbiol Immunol Scand A. 1984 Sep;92(5):323-9. doi: 10.1111/j.1699-0463.1984.tb04411.x.
Recently, placental alkaline phosphatase (PLAP) has been suggested as a tumour marker in patients with seminomas (S), since elevated serum levels of PLAP were found with high frequency in these patients. The present immunoperoxidase study of 33 testicular germ cell tumours was undertaken to localize PLAP in the various types of these tumours as well as in the carcinoma-in-situ (CIS) pattern. Eighteen out of 19 (95%) S were PLAP positive compared to nine out of 14 (64%) non-seminomas (NS). In the NS the positive staining reaction was localized to tumour components of embryonal carcinoma (EC) in six cases, of choriocarcinoma (CC) in one and of S in two, while components of yolk sac tumour and teratoma were PLAP negative. The number of positively stained cells in S was much higher than in EC. The staining reaction was pronounced in the syncytiotrophoblast of CC and in some syncytiotrophoblast-like cells present in S. The staining reaction product was mainly confined to the cell membrane in the positive tumour types. In 20 out of 24 cases with CIS various numbers of CIS cells were PLAP positive, while PLAP was not found in normal germinal epithelium. Sixty three per cent of S patients had serum values above 1.0 micrograms/l, while such values occurred in 21% of NS patients. The tissue staining pattern for PLAP was found to correspond to the preoperative serum value. On the basis of these findings it is concluded that PLAP may be a useful marker in patients with S. Serum levels of PLAP may be used diagnostically in patients with testicular tumours and for monitoring therapy and detection of recurrences in patients with S. For optimal utility of this marker, determinations of serum profiles of PLAP are recommended. Finally, demonstration of PLAP in CIS indicates a functional relationship between CIS and S supporting the hypothesis that CIS is the precursor state of these tumours.
最近，有人提出胎盘碱性磷酸酶（PLAP）可作为精原细胞瘤（S）患者的肿瘤标志物，因为在这些患者中经常发现血清PLAP水平升高。本研究采用免疫过氧化物酶法对33例睾丸生殖细胞肿瘤进行研究，以确定PLAP在这些肿瘤的不同类型以及原位癌（CIS）中的定位。19例S中有18例（95%）PLAP呈阳性，相比之下，14例非精原细胞瘤（NS）中有9例（64%）呈阳性。在NS中，6例胚胎癌（EC）、1例绒毛膜癌（CC）和2例S的肿瘤成分呈阳性染色反应，而卵黄囊瘤和畸胎瘤成分PLAP呈阴性。S中阳性染色细胞的数量远高于EC。CC的合体滋养层以及S中存在的一些合体滋养层样细胞中染色反应明显。在阳性肿瘤类型中，染色反应产物主要局限于细胞膜。24例CIS中有20例不同数量的CIS细胞PLAP呈阳性，而正常生精上皮中未发现PLAP。63%的S患者血清值高于1.0微克/升，而NS患者中这一比例为21%。发现PLAP的组织染色模式与术前血清值相符。基于这些发现得出结论，PLAP可能是S患者的一种有用标志物。PLAP血清水平可用于睾丸肿瘤患者的诊断，以及S患者的治疗监测和复发检测。为了使该标志物发挥最佳效用，建议测定PLAP的血清谱。最后，CIS中PLAP的显示表明CIS与S之间存在功能关系，支持了CIS是这些肿瘤的前驱状态这一假说。
