title: Significance of human chorionic gonadotropin, alpha-fetoprotein, and pregnancy-specific beta-1-glycoprotein in the detection of tumor relapse and partial remission in 126 patients with nonseminomatous testicular germ cell tumors.
abstract: After surgery and initial treatment, 126 patients with nonseminomatous germ cell tumors of the testis were followed by estimation of serum human chorionic gonadotropin (HCG), alpha-fetoprotein (AFP), and pregnancy-specific beta-1-glycoprotein (SP-1). The median follow-up time was 39 months (range, 12-69 months). An evaluation was made of the sensitivity, specificity, and predictive value of these markers to detect tumor relapse (TR) and partial remission (PR) rates. Five of the 35 (14%) Stage I patients had a TR, and in 4 the TR was recognized early by increasing serum levels of HCG (four times) and AFP (one time). In Stage II and III disease 17 of the 91 (18%) patients had a TR or PR. In 15 of the 17 patients TR and PR were associated with elevated serum levels of HCG (nine times), AFP (seven times), and SP-1 (five times). Rising levels of HCG and/or AFP preceded a clinical confirmation of TR and PR by 4 to 8 weeks. Serum SP-1 did not add useful information. The combined use of serum HCG and AFP gives a sensitive indicator for TR and PR: 19 of 22 (86%) of such patients were recognized. The specificity (98% and 100%, respectively) and the predictive value of positive tests (87% and 100%, respectively) were high for both HCG and AFP.
authors.forename: H W
authors.initials: HW
authors.lastname: de Bruijn
authors.forename: D T
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: H
authors.initials: H
authors.lastname: Schraffordt Koops
authors.forename: A J
authors.initials: AJ
authors.lastname: Suurmeijer
authors.forename: J
authors.initials: J
authors.lastname: Marrink
authors.forename: T
authors.initials: T
authors.lastname: Ockhuizen
mesh_terms: D006063:Chorionic Gonadotropin / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood*; D011257:Pregnancy Proteins / Q000097:blood*; D011268:Pregnancy-Specific beta 1-Glycoproteins / Q000097:blood*; D013736:Testicular Neoplasms / Q000097:blood* / Q000628:therapy; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D006063:Chorionic Gonadotropin; D011257:Pregnancy Proteins; D011268:Pregnancy-Specific beta 1-Glycoproteins; D000509:alpha-Fetoproteins