The Role of Alphafetoprotein and Human Chorionic Gonadotropin in Seminoma

No AccessJournal of Urology1 Dec 1978The Role of Alphafetoprotein and Human Chorionic Gonadotropin in Seminoma N. Javadpour, K.R. Mcintire, T.A. Waldmann, and S.M. Bergman N. JavadpourN. Javadpour , K.R. McintireK.R. Mcintire , T.A. WaldmannT.A. Waldmann , and S.M. BergmanS.M. Bergman View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)57330-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Abstract: In a prospective study of 60 patients with pure seminoma we have measured the levels of serum human chorionic gonadotropin and alpha-fetoprotein by specific double antibody immunoassays developed originally at the National Cancer Institute, These markers also were localized in different cells using the techniques of immunoperoxidase and immunofluorescence on serial sections of the tumors. Of 60 patients 4 had elevated serum human chorionic gonadotropin, with a range of 2.8 to 428ng./ml. and an average of 109ng./ml. In serial sectioning of the tumor specimens 1 of 4 patients had an element of choriocarcinoma and underwent retroperitoneal lymph node dissection and chemotherapy. The serum human chorionic gonadotropin decreased to normal. Normal levels of alpha-fetoprotein were seen in 59 patients. However, in 1 patient the serum alpha-fetoprotein was 152ng./ml. In serial sectioning an element of embryonal carcinoma was found. This patient has been proved to have metastatic involvement of aortocaval nodes and underwent retroperitoneal lymphadenectomy. Histopathological examination showed an element of embryonal carcinoma. In this prospective study we concluded that 1) the frequency of elevated human chorionic gonadotropin in the serum of patients with seminoma is about 5 per cent (3 of 60 patients), 2) although the giant tumor cell occasionally found in pure seminoma is capable of secreting human : chorionic gonadotropin one must look for elements of choriocarcinoma and/or embryonal carcinoma, which change the therapeutic approach, 3) the elevated serum alpha-fetoprotein in patients with seminoma indicates the presence of an element of embryonal carcinoma that also changes the therapeutic approach, 4) the reported cases of seminoma with an elevated level of human chorionic gonadotropin in the literature are lacking serial sections and/or localization of cellular human chorionic gonadotropin and, therefore, we must be cautious in accepting them as pure seminoma and 5) the preliminary results in patients with seminoma and elevated serum human chorionic gonadotropin, even in the absence of choriocarcinoma, suggest to us that lymph node dissection and/or chemotherapy probably is the treatment of choice. However, the ultimate proof for this approach must await the results of a prospective study as far as survival isconcerned. © 1978 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByMirimanoff R, Shipley W, Dosoretz D and Meyer J (2018) Pure Seminoma of The Testis: The Results of Radiation Therapy in Patients with Elevated Human Chorionic Gonadotropin TitersJournal of Urology, VOL. 134, NO. 6, (1124-1126), Online publication date: 1-Dec-1985.Mendenhall W, Williams S, Einhorn L and Donohue J (2018) Disseminated Seminoma: Re-Evaluation of Treatment ProtocolsJournal of Urology, VOL. 126, NO. 4, (493-496), Online publication date: 1-Oct-1981.Lange P, Nochomovitz L, Rosai J, Fraley E, Kennedy B, Bosl G, Brisbane J, Catalona W, Cochran J, Comisarow R, Cummings K, deKernion J, Einhorn L, Hakala T, Jewett M, Moore M, Scardino P and Streitz J (2018) Serum Alpha-Fetoprotein and Human Chorionic Gonadotropin in Patients with SeminomaJournal of Urology, VOL. 124, NO. 4, (472-478), Online publication date: 1-Oct-1980. Volume 120Issue 6December 1978Page: 687-690 Advertisement Copyright & Permissions© 1978 by The American Urological Association Education and Research, Inc.MetricsAuthor Information N. Javadpour More articles by this author K.R. Mcintire More articles by this author T.A. Waldmann More articles by this author S.M. Bergman More articles by this author Expand All Advertisement PDF DownloadLoading ...