Histological Patterns in Germ‐cell Tumours associated with Raised Serum Alpha‐fetoprotein (AFP)

Abstract

Serum alpha‐fetoprotein (AFP) was studied in 237 patients with germ cell neoplasms of the gonads and extra‐gonadal sites. Whenever possible serial determinations were performed. All patients in remission had normal serum AFP. Raised serum AFP was seen in patients with active disease whose tumours contained endodermal sinus tumour (EST). This included 29 patients with testicular tumours, 11 with ovarian, 3 with mediastinal, and one with a retroperitoneal tumour. In all these patients serum AFP levels were high and correlated well with the amount of EST within the tumour. Serum AFP became normal when the disease was eradicated. There was a gradual rise with recurrence of the disease. Slightly raised serum AFP (below 60 ng/ml) was present in two patients with embryonal carcinoma examined preoperatively. In four similar cases serum AFP was normal. All patients with pure teratoma had normal serum AFP. Seventeen patients with pure seminoma whose serum was examined preoperatively had normal serum AFP at all times. These findings indicate that raised serum AFP is associated with the presence of EST within the tumour, and AFP is a good and reliable tumour marker in patients with germ cell neoplasms containing EST.