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Lectin‐reactive alpha‐fetoprotein as a marker for testicular tumor activity
Author(s) -
KAWAI KOJI,
KOJIMA TAKAHIRO,
MIYANAGA NAOTO,
HATTORI KAZUNORI,
HINOTSU SHIRO,
SHIMAZUI TORU,
AKAZA HIDEYUKI
Publication year - 2005
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2005.01032.x
Subject(s) - seminoma , medicine , alpha fetoprotein , tumor marker , testicular germ cell tumor , orchiectomy , hepatocellular carcinoma , gastroenterology , pathology , urology , cancer , chemotherapy
Background: Lens culinaris agglutin (LCA)‐affinity electrophoresis resolves serum α‐fetoprotein (AFP) into three isoforms, AFP‐L1, ‐L2 and ‐L3. The ratio of AFP‐L3 to total AFP (AFP‐L3%) is frequently high in hepatocellular carcinoma (HCC) patients, and thus, it is widely used for early diagnosis of HCC. In the present study, we used the subfraction profile of LCA‐binding AFP to diagnose and monitor testicular tumor activity. Methods: Serum samples were collected from 21 testicular tumor patients, and the LCA‐reactive fractions were determined by LCA‐affinity electrophoresis coupled with antibody‐affinity blotting. The histological diagnosis was non‐seminomatous germ cell tumor (NSGCT) in 15 patients and pure seminoma in six patients. Results: Serum AFP levels were abnormally elevated (>20 ng/mL) in 10 of 15 NSGCT patients. One NSGCT patient and two seminoma patients showed borderline AFP levels between 10 and 20 ng/mL. LCA‐reactive AFP was detected in all 11 NSGCT patients with serum AFP levels above 10 ng/mL, but not in the two seminoma patients with serum AFP levels above 10 ng/mL. In testicular tumor patients, the broad band of AFP‐L2 could not be completely separated from AFP‐L3. The mean ratio of AFP‐L3 plus AFP‐L2 (AFP‐L2 + 3%) was as high as 94% (range 80–99%) in these patients. Serial determinations of LCA‐reactive fractions were performed in eight of the 11 LCA‐reactive AFP‐positive patients. They included five patients who received chemotherapy, and three patients who underwent orchiectomy for stage I NSGCT. In three of eight patients, LCA‐reactive AFP was detected even after normalization of total AFP levels. All three patients relapsed, with elevation of serum AFP within several months. Conclusion: Determination of LCA‐reactive AFP might be a useful marker for testicular tumor activity in patients with lower AFP levels.