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

1. 对23例原发性颅内生殖细胞瘤（17例生殖细胞瘤、1例胚胎癌、1例卵黄囊瘤、3例畸胎瘤、1例畸胎瘤合并胚胎癌）和6例原发性松果体非生殖细胞瘤（1例松果体细胞瘤、2例松果体母细胞瘤、2例星形细胞瘤、1例胶质母细胞瘤）进行了间接免疫过氧化物酶检测。17例颅内生殖细胞瘤中有13例（76.5%）的胎盘碱性磷酸酶（PLAP）主要在肿瘤细胞膜上染色阳性。在6例原发性颅内非生发性生殖细胞瘤中，仅1例胚胎癌的少数细胞和1例畸胎瘤的部分腺上皮细胞呈弱阳性染色，提示存在PLAP；这种染色仅限于细胞质。其余6例松果体非生殖细胞肿瘤均未见PLAP阳性反应。对85例（颅内29例，睾丸56例）生殖细胞瘤进行免疫组化研究。生殖细胞瘤（精原细胞瘤）成分52例。其中48例（92.3%）含有较多plap阳性肿瘤细胞。畸胎瘤成分20例。20例患者中，5例（25.0%）发现部分plap阳性腺上皮细胞。胚胎癌成分14例。其中4例（28.6%）含有部分plap阳性肿瘤细胞。卵黄囊肿瘤成分12例。只有1例（8.3%）有多个肿瘤细胞显示PLAP阳性反应。绒毛膜癌成分4例。4例患者中3例（75.0%）有少量PLAP反应阳性的合胞滋养细胞肿瘤细胞。建立了一种用于评估PLAP的灵敏酶联免疫吸附试验（ELISA），并用于检查各种脑肿瘤患者的PLAP测量。测定了47例对照成年男性血清和20例非妊娠蛛网膜下腔出血患者脑脊液中PLAP水平。上述样品血清和脑脊液的上限分别为0.29和0.11 IU/L。68例脑肿瘤除生殖细胞瘤（2例畸胎瘤，1例卵黄囊瘤合并畸胎瘤，1例睾丸转移性绒毛膜癌，14例胶质母细胞瘤，18例星形细胞瘤，19例脑膜瘤，13例神经瘤）外，血清PLAP水平均在0.29 IU/L以下。6例生殖细胞瘤患者中有5例血清PLAP水平升高（0.52至3.78 IU/L）， 5例患者中有4例脑脊液LPAP水平升高（0.83至9.83 IU/L）。2例生殖细胞瘤的瘤内囊肿液中PLAP含量很高（603和863 IU/L）。这些研究强烈提示PLAP是颅内生殖细胞瘤的一个有用的肿瘤标志物，不仅在病理组织学上，而且在临床上。少

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