肿瘤标志物对中枢神经系统生殖细胞肿瘤诊断、治疗和预后的影响:与临床实践和组织病理学的相关性

IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY
Hirokazu Takami, Christopher S Graffeo, Avital Perry, Caterina Giannini, Yoichi Nakazato, Nobuhito Saito, Masao Matsutani, Ryo Nishikawa, David J Daniels, Koichi Ichimura
{"title":"肿瘤标志物对中枢神经系统生殖细胞肿瘤诊断、治疗和预后的影响:与临床实践和组织病理学的相关性","authors":"Hirokazu Takami,&nbsp;Christopher S Graffeo,&nbsp;Avital Perry,&nbsp;Caterina Giannini,&nbsp;Yoichi Nakazato,&nbsp;Nobuhito Saito,&nbsp;Masao Matsutani,&nbsp;Ryo Nishikawa,&nbsp;David J Daniels,&nbsp;Koichi Ichimura","doi":"10.1007/s10014-023-00460-x","DOIUrl":null,"url":null,"abstract":"<p><p>Tumor markers in CNS germ cell tumors (GCTs) include human chorionic gonadotropin (HCG) and alpha fetoprotein (AFP), which have significant diagnostic implications, as elevation of either one leads to clinical diagnosis of non-germinomatous GCTs without histopathological confirmation, justifying intensified chemotherapy and irradiation. The current study, based on an international cohort of histopathologically verified GCTs that underwent biopsy (n = 85) or resection (n = 76), sought to better define the clinical role and prognostic significance of tumor markers from serum and CSF in this challenging patient population. We found that HCG was elevated only in cases with a germinoma or choriocarcinoma component, and there existed a clear cut-off HCG value between the two. AFP was often elevated in GCTs without a yolk sac tumor component, especially immature teratoma. HCG was elevated only in CSF in 3-of-52 cases, and AFP was elevated only in serum in 7-of-49 cases, emphasizing the potential utilization of both serum and CSF studies. Immature teratoma demonstrated unfavorable prognosis independent of tumor marker status, with 56% 5-year overall survival; however, co-existent germinoma components indicated a more favorable prognosis. Taken together, the study findings emphasize the importance for routine assessment and guarded interpretation of tumor markers in CNS GCTs.</p>","PeriodicalId":9226,"journal":{"name":"Brain Tumor Pathology","volume":"40 2","pages":"124-132"},"PeriodicalIF":2.7000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113344/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of tumor markers on diagnosis, treatment and prognosis in CNS germ cell tumors: correlations with clinical practice and histopathology.\",\"authors\":\"Hirokazu Takami,&nbsp;Christopher S Graffeo,&nbsp;Avital Perry,&nbsp;Caterina Giannini,&nbsp;Yoichi Nakazato,&nbsp;Nobuhito Saito,&nbsp;Masao Matsutani,&nbsp;Ryo Nishikawa,&nbsp;David J Daniels,&nbsp;Koichi Ichimura\",\"doi\":\"10.1007/s10014-023-00460-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Tumor markers in CNS germ cell tumors (GCTs) include human chorionic gonadotropin (HCG) and alpha fetoprotein (AFP), which have significant diagnostic implications, as elevation of either one leads to clinical diagnosis of non-germinomatous GCTs without histopathological confirmation, justifying intensified chemotherapy and irradiation. The current study, based on an international cohort of histopathologically verified GCTs that underwent biopsy (n = 85) or resection (n = 76), sought to better define the clinical role and prognostic significance of tumor markers from serum and CSF in this challenging patient population. We found that HCG was elevated only in cases with a germinoma or choriocarcinoma component, and there existed a clear cut-off HCG value between the two. AFP was often elevated in GCTs without a yolk sac tumor component, especially immature teratoma. HCG was elevated only in CSF in 3-of-52 cases, and AFP was elevated only in serum in 7-of-49 cases, emphasizing the potential utilization of both serum and CSF studies. Immature teratoma demonstrated unfavorable prognosis independent of tumor marker status, with 56% 5-year overall survival; however, co-existent germinoma components indicated a more favorable prognosis. Taken together, the study findings emphasize the importance for routine assessment and guarded interpretation of tumor markers in CNS GCTs.</p>\",\"PeriodicalId\":9226,\"journal\":{\"name\":\"Brain Tumor Pathology\",\"volume\":\"40 2\",\"pages\":\"124-132\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113344/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brain Tumor Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10014-023-00460-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain Tumor Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10014-023-00460-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

中枢神经系统生殖细胞肿瘤(gct)的肿瘤标志物包括人绒毛膜促性腺激素(HCG)和甲胎蛋白(AFP),这两种标志物具有重要的诊断意义,因为其中任何一种的升高都会导致临床诊断为非生发性gct,而无需组织病理学证实,证明强化化疗和放疗是合理的。目前的研究基于一组组织病理学验证的gct国际队列,这些gct接受活检(n = 85)或切除(n = 76),旨在更好地定义来自血清和脑脊液的肿瘤标志物在这一具有挑战性的患者群体中的临床作用和预后意义。我们发现HCG仅在有生殖细胞瘤或绒毛膜癌成分的病例中升高,两者之间存在明确的临界值。在没有卵黄囊肿瘤成分的gct中,尤其是未成熟畸胎瘤,AFP经常升高。52例中3例仅CSF中HCG升高,49例中7例仅血清中AFP升高,强调血清和CSF研究的潜在应用价值。未成熟畸胎瘤表现出与肿瘤标志物无关的不良预后,其5年总生存率为56%;然而,同时存在的生殖细胞瘤成分表明预后较好。综上所述,研究结果强调了对中枢神经系统gct中肿瘤标志物进行常规评估和谨慎解释的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Impact of tumor markers on diagnosis, treatment and prognosis in CNS germ cell tumors: correlations with clinical practice and histopathology.

Impact of tumor markers on diagnosis, treatment and prognosis in CNS germ cell tumors: correlations with clinical practice and histopathology.

Impact of tumor markers on diagnosis, treatment and prognosis in CNS germ cell tumors: correlations with clinical practice and histopathology.

Impact of tumor markers on diagnosis, treatment and prognosis in CNS germ cell tumors: correlations with clinical practice and histopathology.

Tumor markers in CNS germ cell tumors (GCTs) include human chorionic gonadotropin (HCG) and alpha fetoprotein (AFP), which have significant diagnostic implications, as elevation of either one leads to clinical diagnosis of non-germinomatous GCTs without histopathological confirmation, justifying intensified chemotherapy and irradiation. The current study, based on an international cohort of histopathologically verified GCTs that underwent biopsy (n = 85) or resection (n = 76), sought to better define the clinical role and prognostic significance of tumor markers from serum and CSF in this challenging patient population. We found that HCG was elevated only in cases with a germinoma or choriocarcinoma component, and there existed a clear cut-off HCG value between the two. AFP was often elevated in GCTs without a yolk sac tumor component, especially immature teratoma. HCG was elevated only in CSF in 3-of-52 cases, and AFP was elevated only in serum in 7-of-49 cases, emphasizing the potential utilization of both serum and CSF studies. Immature teratoma demonstrated unfavorable prognosis independent of tumor marker status, with 56% 5-year overall survival; however, co-existent germinoma components indicated a more favorable prognosis. Taken together, the study findings emphasize the importance for routine assessment and guarded interpretation of tumor markers in CNS GCTs.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Brain Tumor Pathology
Brain Tumor Pathology 医学-病理学
CiteScore
5.40
自引率
9.10%
发文量
30
审稿时长
>12 weeks
期刊介绍: Brain Tumor Pathology is the official journal of the Japan Society of Brain Tumor Pathology. This international journal documents the latest research and topical debate in all clinical and experimental fields relating to brain tumors, especially brain tumor pathology. The journal has been published since 1983 and has been recognized worldwide as a unique journal of high quality. The journal welcomes the submission of manuscripts from any country. Membership in the society is not a prerequisite for submission. The journal publishes original articles, case reports, rapid short communications, instructional lectures, review articles, letters to the editor, and topics.Review articles and Topics may be recommended at the annual meeting of the Japan Society of Brain Tumor Pathology. All contributions should be aimed at promoting international scientific collaboration.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信