Histo pathological and clinical application of placental alkaline phostaphase as a tumor maker for primary intracranial germinoma.

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1. Indirect immunoperoxidase ataining was carried out on 23 primary intracranial germ-cell tumors (17 germinomas, 1 embryonal carcinoma, 1 yolk sac tumor, 3 teratomas, and 1 teratoma with embryonal carcinoma) and on 6 primary pineal non-germ-cell tumors (1 pineocytoma, 2 pineoblastomas, 2 astrocytomas, and 1 glioblastoma). Thirteen of 17 intracranial germinomas (76.5%) showed positive staining for placental alkaline phosphatase (PLAP) mainly on the tumor cell membrane. In 6 primary intractanial non-germinomatous germ-cell tumors, there was weak positive staining indicating the presence of PLAP only a few cells of one embryonal carcinoma, and in some glandular epithelial cells of one teratoma; This staining was limited to the cytoplasm. None of the other 6 pineal non-germ-cell tumors showed any positive PLAP reaction.2. Eighty-five (29 intracranial and 56 testicular) germ-cell tumors were studied immunohistochemically. Germinoma (seminoma) component was seen in 52 cases. Forty-eight of … More these cases (92.3%) contained many PLAP-positive tumor cells. Teratoma component was seen in 20 cases. In the 20 cases, 5 (25.0%) were found to have some PLAP-positive glandular epithelial cells. Embryonal carcinoma component was seen in 14 cases. Four of these cases (28.6%) contained some of PLAP-positive tumor cells. Yolk sac tumor component was seen 12 cases. Only one of the cases (8.3%) had several tumor cells showing a positive reaction for PLAP. Choriocarcinoma component was seen in 4 cases. In the 4 cases, 3(75.0%) were found to have a small number of syncytiotrophoblastic tumor cells showing a positive PLAP reaction.3. A sensitive enzyme-limked immunoabsorbent assay (ELISA) for assessing PLAP was established and used in an examination of PLAP measurement in varous brain tumorpatiens. The PLAP levels in serum of 47 control adult male individuals and in the CSF of 20 non-prehnant patients of subarachnoid hemorrhage were measured. The upper limits of the above samples were 0.29 and 0.11 IU/L in the serum and the CSF, respectively. All of the PLAP levels in sera of 68 patients with various brain tumors expect germinoma (2 teratomas, 1 yolk sac tumor with immture teratoma, 1 metastatic choriocarcinoma from the testis, 14 glioblastomas, 18 astrocytomas, 19 meningiomas, and 13 neurinomas) were 0.29 IU/L or less. Five of 6 germinoma patients had elevated PLAP levels in their serum (0.52 to 3.78 IU/L) and 4 of 5 also had elevated LPAP levels in their CSF (0.83 to 9.83 IU/L). PLAP levels in the intratumoral cyst fluid of 2 germinomas were very high (603 and 863 IU/L).4. These studies strongly suggests that PLAP is a useful tumor marker for primary in intracranial germinoma not only histopathologically but also clinically. Less