小儿肝母细胞瘤和卵黄囊瘤血清AFP测定

Determination of serum AFP in infants with hepatoblastoma and yolk-sac tumors

目的:探讨监测血清AFP对小儿肝母细胞瘤和卵黄囊瘤诊断和预后的意义。方法:采用放射免疫分析法对肿瘤组(139例小儿实体肿瘤,包括肝母细胞瘤13例,卵黄囊瘤28例,良性畸胎瘤26例,神经母细胞瘤11例,肾母细胞瘤31例,血管瘤、淋巴管瘤30例)肿瘤切除前后、新生儿黄疸组(包括25例新生儿肝炎和9例胆道闭锁)和对照组(40名非肿瘤住院患儿)血清AFP进行测定。肿瘤患者术后进行了3个月～5 a随访。结果:肝母细胞瘤和卵黄囊瘤术前血清AFP阳性率分别为85％,93％。良性畸胎瘤、神经母细胞瘤、肾母细胞瘤、血管瘤和淋巴管瘤等实体肿瘤术前血清AFP阳性率小于23％。手术切除肿瘤后AFP多在手术后2～6周恢复正常。正常对照组血清AFP均阴性。新生儿黄疸组阳性率高达88％。结论:测定AFP可作为诊断小儿肝母细胞瘤和卵黄囊瘤及判断肿瘤是否被完整切除和手术后有无复发的重要依据之一。判断AFP结果时应注意排除新生儿肝胆非肿瘤疾病引起的假阳性结果。

Aim : To investigate the diagnosis and predication value of serum AFP in infants with hepatoblastoma and yolk-sac tumors. Methods: The serum AFP levels were studied by an immunoradiometric assay in 139 infants with solid tumors including hepatoblastoma and yolk-sac tumor, etc, 34 newborns with jaundice and 40 children who were hospitalized for other diseases. Results: AFP was significantly increased in 85% patients with hepatoblastoma and 93% patients with yolk-sac tumors. AFP was less than 23% of infants with Wilm's tumor and other benign solid tumors, and 88% of newborns with jaundice was AFP-positive. AFP in control was negative. Conclusion: When using serum AFP as an important marker to diagnose and predict hepatoblastoma and yolk-sac tumors, more attentions should be paid to newborns with jaundice.