函数法分析AFP和β-hCG在睾丸肿瘤中的变化  

Changes of AFP and β-hCG in testicular tumors analyzed by a function method

作　　者：关晓峰[1] 邓耀良[1] 刘启明[2] 周德雄[2] 杨玉恺[2] 陆鲲[2] 李飞[2] 

机构地区：[1]广西医科大学第一附属医院泌尿外科,广西南宁530021 [2]荆州市第二人民医院泌尿外科,湖北荆州434000

出　　处：《中华男科学杂志》2013年第1期59-62,共4页National Journal of Andrology

摘　　要：目的:建立一种函数法分析AFP和β-hCG在睾丸肿瘤中变化的方法。方法:首先在睾丸根治术后复查AFP和β-hCG并计算其实测值坐标:以癌标实测值的半衰期个数为横坐标,癌标实测值的对数值为纵坐标。其次计算预测值坐标:设术前癌标实测值为a,半衰期个数为x,经过x个半衰期后预测值的对数值为y(以2为底取对数):y=log22axx+y=log2a(公式1),根据公式推导预测值坐标。最后比较癌标实测值与预测值坐标,了解是否有睾丸肿瘤残留或转移。结果:病例1为卵黄囊瘤和合体滋养层细胞的混合性生殖细胞瘤。其AFP和β-hCG在术后第10天的实测值坐标分别为(2.22,6.21)和(10,8.38),预测值坐标分别为(2.22,6.34)和(10,4.41)。该结果提示卵黄囊瘤尚未出现转移,合体滋养层细胞已出现转移。病例2为恶性畸胎瘤和卵黄囊瘤的混合性生殖细胞瘤,其AFP和β-hCG在术后第12天的实测值坐标分别为(2.67,-1.03)和(12,-3.32),预测值坐标分别为(2.67,1.41)和(12,-5.80)。但复查AFP和β-hCG的时间分别为2.67和12个半衰期,超过半衰期有效区间,此时癌标实测值均小于其正常值,可认为肿瘤无残留或转移。病例3为胚胎癌,其AFP在术后第1天的实测值坐标为(0.22,9.25),预测值坐标为(0.22,9.55),该结果提示胚胎癌尚未出现转移。结论:该方法预测的3例患者癌标变化均与实际病程吻合,睾丸根治术后如癌标实测值坐标与预测值坐标吻合,提示肿瘤尚未转移;如不吻合,则提示睾丸肿瘤残留或转移可能。[Abstract] Objective： To establish a new function method for the analysis of ct-fetoprotein （AFP） and β-hCG in testicular tumors. Methods ： We reexamined the serum levels of AFP and β-hCG after radical orchiectomy, and calculated the measured coordi- nate, with the abscissa representing the number of the half-lives of tumor markers, and the ordinate representing the measured value of tumor markers. Referring to the measured value of tumor markers before surgery as a, the number of half-lives as x, and their theoreti- cal value over a period of x elimination half-lives as y （ logarithm to the base 2 of y） , we calculated the predicted coordinate according a to the formula y = log2^2x=x ＋ y = log2 ^＆（function 1 ）. Then we assessed tumor residue and metastasis by analyzing the relationship be- tween the measured and predicted coordinates. Results ： The pathological examination of case 1 revealed a germ cell tumor of a mixed histological pattern of syncytiotrophoblast and yolk sac tumor. The measured coordinates of AFP and β-hCG were （2.22, 6.21 ） and （10, 8.38）, and the predicted coordinates （2.22, 6.34） and （10, 4.41 ）, indicating the elimination of the yolk sac tumor and me-tastasis of the syncytiotrophoblast tumor. Case 2 demonstrated the mixed pathological nature of teratocarcinoma and yolk sac tumor. The measured coordinates of AFP and 13-hCG were （2.67, - 1.03） and （ 12, -3.32）, and the predicted coordinates （2.67, 1.41） and （12, -5.80）. But the review times of AFP and β-hCG were out of the effective range of half-lives, with the measured values below the normal, which suggested no tumor residue or metastasis. Case 3 was found to be embryonal carcinoma. The measured coordinate of AFP was （0.22, 9.25）, and the predicted coordinate （0.22, 9.55）, indicating the elimination of tumor. Conclusion ： The change of the tumor markers predicted by the function method coincided with the natural course of disease in the three cases. The coincidence of the

关 键 词：睾丸肿瘤 甲胎蛋白 人绒毛膜促性腺激素 函数法 

分 类 号：R737.21[医药卫生—肿瘤]