【异常的甲胎蛋白分离提供了额外的信息:一例腹膜后生殖细胞肿瘤伴C型肝硬化】。

Masamune Aihara, Kazuhito Gotoh, Kanae Maruyama, Motoko Yamanaka, Miyuki Sakemoto, Hideo Suzuki, Masaki Kato, Taeko Hotta, Dongchon Kang
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摘要

大多数生殖细胞肿瘤起源于性腺。然而,5%的恶性生殖细胞肿瘤发生在生殖道外器官。由于腺外生殖细胞瘤(eggct)可在松果体、纵隔和腹膜后等中线的任何地方发现,因此这类肿瘤的起源一直存在争议。egct常见于儿童期和青年期;极少见老年患者行EGGCT检查。我们在此报告一例甲胎蛋白(AFP)异常分异对腹膜后生殖细胞瘤的诊断有帮助。一位由慢性丙型肝炎引起的肝硬化的老年男性在计算机断层扫描上显示腹膜内肿瘤样肿块,因此怀疑肝细胞癌。血清学检测显示总AFP水平和AFP- l3 %升高。后者是浓缩AFP在凝集素亲和分离上的比例。值得注意的是,该患者AFP的分离模式异常,提示AFP在生殖细胞肿瘤中具有不同的凝集素亲和力。该患者还表现出非典型的人绒毛膜促性腺激素(8hCG)升高。我们建议在怀疑为肝细胞癌的患者中检测到异常AFP断裂模式时,检测6hCG可用于腹膜后生殖细胞瘤和肝细胞癌的早期鉴别诊断。简短的沟通。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[An Abnormal Alpha-Fetoprotein Fractionation Provides Additional Information: A Case of Retroperitoneal Germ Cell Tumor Accompanied by Liver Cirrhosis Type C].

Most of germ cell tumor is gonadal origin. However 5% of malignant germ cell tumors appear in extragonadal organs. Because extragonadal germ cell tumors (EGGCTs) are found anywhere on the midline such as pineal gland, mediastinum and retroperitoneum, the origin of this type of tumor is controversial. EGGCTs are often seen between childhood and young adult; an elderly patient with EGGCT is rarely met. Here we report a case that an abnormal alpha-fetoprotein (AFP) fractionation pattern was helpful for diagnosis of retroperitoneal germ cell tumor. A presenile man with hepatic cirrhosis caused by chronic hepatitis C showed an intraperitoneal tumor-like mass on computed tomography and thus hepatocellular carcinoma was suspected. A serological test re- vealed elevated total AFP level and AFP-L3%. The latter is the proportion of fucosylated AFP on the lectin-affinity based fractionation. Noticeably the fractionation pattern of AFP of this patient was abnormal, sug- gesting a diversity of lectin-affinity of AFP in germ cell tumors. This patient also showed an atypical in- crease in beta human chorionic gonadotropin (8hCG). We suggest the measurement of 6hCG for early differ- ential diagnosis of retroperitoneal germ cell tumor and hepatocellular carcinoma when an abnormal AFP frac- tionation pattern was detected in a patient with suspected hepatocellular carcinoma. [Short Communication].

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