Fukuda H, Yano M, Hyouchi N, Noro A, Suzuki S
Department of Urology, Hamamatsu Medical Center.
Hinyokika Kiyo. 1994 Apr;40(4):357-60.
Alfa-fetoprotein (AFP) is an indispensable examination in the management of non-seminomatous germ cell tumor. However, many liver diseases also frequently show the elevation of AFP. Therefore, it is essential to discriminate between yolk sac-derived component and liver-derived one. A 32-year-old male who had suffered from chronic hepatitis, visited our clinic in December, 1991. He complained of left scrotal atrophy and dull pain. Surgical specimen was histologically diagnosed as embryonal carcinoma with syncytiotrophoblastic giant cell. The levels of tumor markers, such as AFP, beta-human chorionic gonadotropin (beta-HCG), were estimated. Both of them were elevated, and radiographical studies demonstrated metastatic lesions of bilateral lung field and retroperitoneal lymph nodes (RPLN). After three courses of cisplatin based chemotherapy, lung and RPLN metastases diminished and serum beta-HCG had normalized. However, the serum AFP persisted to show an abnormally high concentration. The subfraction profile with lens culinaris hemagglutinin (LCA) was estimated. The one after the first course was compared with the one after third course. The latter one showed complete diminution of peak 2. This implied the diminishment of yolk sac element.
甲胎蛋白（AFP）是非精原细胞性生殖细胞肿瘤管理中不可或缺的检查项目。然而，许多肝脏疾病也常常表现出AFP升高。因此，区分卵黄囊来源成分和肝脏来源成分至关重要。一名32岁患有慢性肝炎的男性于1991年12月前来我院就诊。他主诉左侧阴囊萎缩和钝痛。手术标本经组织学诊断为伴有合体滋养层巨细胞的胚胎癌。对AFP、β-人绒毛膜促性腺激素（β-HCG）等肿瘤标志物水平进行了评估。两者均升高，影像学检查显示双侧肺野和腹膜后淋巴结（RPLN）有转移病灶。经过三个疗程以顺铂为基础的化疗后，肺部和RPLN转移灶缩小，血清β-HCG恢复正常。然而，血清AFP持续显示异常高浓度。对伴刀豆球蛋白A（LCA）的亚组分图谱进行了评估。将第一个疗程后的图谱与第三个疗程后的图谱进行比较。后者显示峰2完全消失。这意味着卵黄囊成分减少。
