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タイトル: | 原発巣病理組織像が単一組織型セミノーマを呈しAFP 高値を伴った非セミノーマ6例の臨床病理学的検討 |
その他のタイトル: | A Clinicopathologic Study of 6 Patients with Histologically Pure Seminoma But Elevated Serum Alpha-Fetoprotein |
著者: | 神鳥, 周也 河合, 弘二 田中, 建 河原, 貴史 池田, 篤史 石塚, 竜太郎 木村, 友和 小島, 崇宏 常楽, 晃 宮崎, 淳 西山, 博之 |
著者名の別形: | Kandori, Shuya Kawai, Koji Tanaka, Ken Kawahara, Takashi Ikeda, Atsushi Ishitsuka, Ryutaro Kimura, Tomokazu Kojima, Takahiro Joraku, Akira Miyazaki, Jun Nishiyama, Hiroyuki |
キーワード: | Seminoma Alpha-fetoprotein Retroperitoneal lymph node dissection |
発行日: | 30-Apr-2017 |
出版者: | 泌尿器科紀要刊行会 |
誌名: | 泌尿器科紀要 |
巻: | 63 |
号: | 4 |
開始ページ: | 139 |
終了ページ: | 143 |
抄録: | Histologically pure seminoma with elevated alpha-fetoprotein (AFP), so-called AFP-positive seminoma, is rare. It is recommended that patients with AFP-positive seminoma be managed as non-seminoma, but the clinical features and prognosis of this disease are not fully understood. In this study, we retrospectively analyzed 6 cases of metastatic AFP-positive seminoma at Tsukuba University Hospital (TUH). AFP was elevated before induction chemotherapy in 4 patients with an average of 1, 372 ng/ml. In the remaining 2 patients, AFP became elevated during or after induction chemotherapy. In all 4 patients examined, AFPL3% was abnormally increased. As induction chemotherapy, all patients received bleomycin, etoposide and cisplatin (BEP), which was then followed by etoposide, ifosfamide and cisplatin (VIP) in 3 patients. After or during induction chemotherapy, 3 patients suffered from disease progression accompanied by AFP elevation. All 3 were treated by salvage chemotherapy and surgery. Four patients underwent retroperitoneal lymph node dissection (RPLND) after induction chemotherapy ; the pathological findings were necrosis in 3 patients, and viable nonseminomatous cancer in 1 patient. Furthermore, RPLND was performed as salvage surgery in 3 patients ; the pathological findings were necrosis, viable nonseminomatous cancer and teratoma with malignant transformation, respectively. The 5-year progression-free survival rate of the 6 patients was 50%, which is somewhat inferior to that of poor-prognosis non-seminoma patients treated at TUH. One patient ultimately died of cancer, and the remaining 5 are in remission with a median follow-up of 58 months. The present study demonstrates that AFP-positive seminoma patients have a higher risk of relapse compared to non-seminoma patients. |
著作権等: | 許諾条件により本文は2018/05/01に公開 |
DOI: | 10.14989/ActaUrolJap_63_4_139 |
URI: | http://hdl.handle.net/2433/224874 |
PubMed ID: | 28506050 |
出現コレクション: | Vol.63 No.4 |
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