Male Genital Tract
Which one of the following is not used as a tumor mar- ker in testicular tumors? (AIPG 2011)
a. Biological markers of germ cell testicular tumors include AFP, hCG, placental alkaline phosphatase, placental lactogen and LDH. AFP, hCG and LDH are widely used clinically and have proved to be valuable in the diagnosis and management of testicular cancer'
b. CEA is an onco-fetal antigen and may be used as a tumor marker in adenocarcinoma of colon, pancreas, lung' breast and ovary. It is however not used as marker for Germ cell tumors.
c. About 70% patient with non-seminomatous germ cell tumors (NSGCT) show increased concentration of AFP or hCG. Latter may also be elevated in 10% of seminomas. But AFP is never increased in seminoma.
"The presence of increased AFP level in a patient whose tumor shows only seminoma indicates that an occult NSGCT component exists" .
a. LDH levels are not as specific as AFP or hCG but are increased in 50-60% patient with NSGCT and up to 80% patients with advanced seminoma.
b. AFP, hCG and LDH levels should be determined before and after orchiectomy. Reappearance of these markers or failure to decline according to predicted half life is an indication of persistent or recurrent tumor.