Germà J R, Llanos M, Tabernero J M, Mora J
Unidad de Oncologia Médica, Hospital de La Santa Creu i Sant Pau, Universidad Autonoma de Barcelona, Spain.
Cancer. 1993 Oct 15;72(8):2491-4. doi: 10.1002/1097-0142(19931015)72:8<2491::aid-cncr2820720829>3.0.co;2-0.
Determination of serum concentration human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) is crucial in diagnosis, prognosis, treatment, and follow-up of patients with germ cell tumors. Elevation of these markers almost indicates progression or recurrence of the germ cell tumor. However, an increase in these tumor markers can be produced by several benign causes.
The authors report nine cases of gonadal germ cell tumors that had increased serum levels of AFP without tumoral progression, recurrence, or residual tumor.
The AFP elevations were attributed to liver damage secondary to drugs (chemotherapy, anesthetics, or antiepileptics), virus, or alcoholism. No clinical evidence (or in some cases surgical evidence) of malignant tumor activity was found in any of the patients.
The elevation of serum levels of AFP in patients with germ cell tumors can be produced by liver dysfunction. These elevations must be interpreted with caution to avoid unnecessary treatments.
血清人绒毛膜促性腺激素（HCG）和甲胎蛋白（AFP）的测定对于生殖细胞肿瘤患者的诊断、预后、治疗及随访至关重要。这些标志物的升高几乎提示生殖细胞肿瘤进展或复发。然而，多种良性原因也可导致这些肿瘤标志物升高。
作者报告了9例性腺生殖细胞肿瘤患者，其血清AFP水平升高，但无肿瘤进展、复发或残留肿瘤。
AFP升高归因于药物（化疗药、麻醉药或抗癫痫药）、病毒或酒精中毒继发的肝损伤。所有患者均未发现恶性肿瘤活动的临床证据（某些病例为手术证据）。
生殖细胞肿瘤患者血清AFP水平升高可能由肝功能障碍引起。必须谨慎解读这些升高情况，以避免不必要的治疗。
