Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Diagnostic value of alpha(1)-fetoprotein and beta-human chorionic gonadotropin in infancy and childhood
Autore:
Schneider, DT; Calaminus, G; Gobel, U;
Indirizzi:
Univ Dusseldorf, Med Ctr, Clin Pediat Hematol & Oncol, D-40225 Dusseldorf,Germany Univ Dusseldorf Dusseldorf Germany D-40225 l, D-40225 Dusseldorf,Germany Johns Hopkins Med Inst, Dept Pathol, Div Pediat Pathol, Baltimore, MD 21205 USA Johns Hopkins Med Inst Baltimore MD USA 21205 ol, Baltimore, MD 21205 USA
Titolo Testata:
PEDIATRIC HEMATOLOGY AND ONCOLOGY
fascicolo: 1, volume: 18, anno: 2001,
pagine: 11 - 26
SICI:
0888-0018(200101/02)18:1<11:DVOAAB>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
SERUM ALPHA-FETOPROTEIN; GERM-CELL-TUMORS; GROWING TERATOMA SYNDROME; MARKER HALF-LIFE; HEREDITARY PERSISTENCE; YOLK-SAC; HEPATOCELLULAR-CARCINOMA; ATAXIA-TELANGIECTASIA; GALLBLADDER CARCINOMA; CLINICAL-SIGNIFICANCE;
Keywords:
AFP; beta-hCG; diagnosis; review; tumor markers;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
94
Recensione:
Indirizzi per estratti:
Indirizzo: Schneider, DT Univ Dusseldorf, Med Ctr, Clin Pediat Hematol & Oncol, Moorenstr 5, D-40225 Dusseldorf, Germany Univ Dusseldorf Moorenstr 5 DusseldorfGermany D-40225 many
Citazione:
D.T. Schneider et al., "Diagnostic value of alpha(1)-fetoprotein and beta-human chorionic gonadotropin in infancy and childhood", PED HEM ONC, 18(1), 2001, pp. 11-26

Abstract

This article provides a comprehensive review of the current literature andsummarizes the experience of the German cooperative protocols for nontesticular germ cell tumors (MAKEI) on the use of alpha(1)-fetoprotein. (AFP) and beta-human chorionic gonadotropin (beta -hCG) for diagnostic evaluation in pediatric oncology. Based on this evaluation, this review proposes guidelines for the initial diagnostic work-up for children with clinically suspected secreting tumors. AFP and beta -hCG represent the characteristic tumor markers of malignant epithelial liver tumors and malignant germ cell tumors(GCT). They play an important role in the initial diagnostic evaluation aswell as in the follow-up examination during therapy. Current therapeutic strategies for both tumor types include preoperative chemotherapy followed by delayed tumor resection. Therefore, it is essential for the pediatrician in charge to be aware of the broad differential diagnosis of elevated AFP and beta -hCG. In a well-defined clinical setting, these tumor markers allowclinical diagnosis without histological confirmation, but the physiologically elevated AFP serum levels in infancy or unrecognized benign conditions,such as hepatic diseases or hereditary disorders, must also be considered as differential diagnoses. Therefore, the laboratory investigations should include liver parameters in all patients to exclude hepatic disease. In addition pregnancy must be excluded in adolescents. Careful history taking andclinical examination will further help to rule out metabolic disorders or ataxia teleangiectasia that are associated with elevated AFP levels. Havingexcluded these conditions, elevated AFP levels above the age-related normal range (with or without high beta -hCG), indicate malignant epithelial liver tumors in primary liver lesions. At virtually all other sites, the diagnosis of a malignant GCT with a substantial yolk sac tumor and/or choriocarcinoma component can be established. Pancreaticoblastoma should be considered in the differential diagnosis of tumors of the upper abdomen, and biopsy must be performed. Other childhood tumors are rarely associated with AFP orbeta -hCG production usually at only moderately elevated serum levels, andin most patients these tumors can be excluded by clinical and radiologicalexamination.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/09/20 alle ore 23:59:19