The Role of Alphafetoprotein and Human Chorionic Gonadotropin in Seminoma

In a prospective study of 60 patients with pure seminoma we have measured the levels of serum human chorionic gonadotropin and alpha-fetoprotein by specific double antibody immunoassays developed originally at the National Cancer Institute, These markers also were localized in different cells using the techniques of immunoperoxidase and immunofluorescence on serial sections of the tumors. Of 60 patients 4 had elevated serum human chorionic gonadotropin, with a range of 2.8 to 428ng./ml. and an average of 109ng./ml. In serial sectioning of the tumor specimens 1 of 4 patients had an element of choriocarcinoma and underwent retroperitoneal lymph node dissection and chemotherapy. The serum human chorionic gonadotropin decreased to normal. Normal levels of alpha-fetoprotein were seen in 59 patients. However, in 1 patient the serum alpha-fetoprotein was 152ng./ml. In serial sectioning an element of embryonal carcinoma was found. This patient has been proved to have metastatic involvement of aortocaval nodes and underwent retroperitoneal lymphadenectomy. Histopathological examination showed an element of embryonal carcinoma.