Serum Tumour Markers

Serum tumour marker concentrations are determined before, during, and after treatment and throughout long-term follow-up. Increased or rising concentrations of alpha-fetoprotein (AFP), human chorionic gonadotrophin (HCG), or both, without radiographic or clinical findings, imply active disease and are sufficient reason to initiate treatment if likely causes of false positive results have been ruled out.

Alpha-fetoprotein: production is restricted to non-seminomatous germ cell tumours, specifically embryonal carcinoma and yolk sac tumours.

HCG: may be observed in both seminomas and non-seminomatous tumours. Lactate dehydrogenase (LDH): is less specific but has independent prognostic value in patients with advanced germ-cell tumours.

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