CLB-08741; No. of page: 1; 4C: Clinical Biochemistry xxx (2014) xxx
Contents lists available at ScienceDirect
Clinical Biochemistry journal homepage: www.elsevier.com/locate/clinbiochem
Short Communication
Clinical relevance of AFP, its molecular variants and HCG in hepatoblastoma and childhood germ cell tumors Tangirala Malati Department of Biochemistry, Nizam's Institute of Medical Sciences, Hyderabad 500008, Andhra Pradesh, India
Summary Childhood cancers are the leading cause of death among children between infancy and age fifteen years. Of these, the pediatric germ cell tumors (GCTs) are a diverse group of neoplasms that account for approximately 3% of all childhood cancers. GCTs arise from primordial cells involved in gametogenesis, are relatively rare and often present as large tumors both in gonadal as well as at extra gonadal sites. Extra gonadal tumors are more common in neonates and infants, whereas tumors in gonads occur predominantly in childhood and adolescence. Pediatric GCTs include germinomas, non-seminomatous GCTs and teratomas [1]. Hepatoblastomas (HB) are very rare malignant neoplasms and account for about 1% of all pediatric tumors. These tumors originate in the liver and affect children from infancy to about 5 years of age. Pediatric liver tumors include hepatoblastoma, hepatocellular carcinoma, sarcoma, GCTs and rhabdoid tumors. The pediatric embryonal tumor HB accounts for 60% of malignant hepatic neoplasms [2]. Serum tumor markers offer great promise in the management of childhood malignancies and are integral to disease diagnosis and prediction of treatment response. Cancer biomarkers are substances that are expressed by malignant tissues, circulating tumor components or generated by the host in response to the tumor. These markers serve as essential tools to aid clinicians in diagnosis, staging and risk
assessments. The two clinically relevant tumor markers in pediatric oncology are the alpha-fetoprotein (AFP) and beta human chorionic gonadotropin (βHCG) [3]. Yolk sac AFP and liver AFP synthesized during fetal and adult lives are immunologically cross-reactive. They exhibit molecular heterogeneity with respect to charge, molecular size and lectin binding properties. The qualitative and quantitative estimations of molecular variants (lectin reactive and lectin non-reactive) of AFP highlighted the clinical relevance in differential diagnosis of AFP secreting tumors. The AFP variants as diagnostic aids also help in providing better management and prognosis. Lastly, a few follow-up case studies will be of help in establishing the importance of AFP and βHCG as diagnostic aid in monitoring the efficacy of cancer treatment and in predicting early tumor recurrence.
References [1] Mosbech CH, Rechnitzer C, Brok JS, Rajpert-De Meyts E, Hoei-Hansen CE. Recent advances in understanding the etiology and pathogenesis of pediatric germ cell tumors. Pediatr Hematol Oncol Feb 26, 2014;36:263–70. [2] Fabre M, Yilmaz F, Buendia MA. Hepatic tumors in childhood: experience on 245 tumors and review of literature. Ann Pathol 2004;24:536–55. [3] Schneider DT, Calaminus G, Göbel U. Diagnostic value of alpha 1-fetoprotein and betahuman chorionic gonadotropin in infancy and childhood. Pediatr Hematol Oncol 2001;18:11–26.
E-mail address: [email protected].
http://dx.doi.org/10.1016/j.clinbiochem.2014.05.035 0009-9120/© 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Please cite this article as: Malati T, Clinical relevance of AFP, its molecular variants and HCG in hepatoblastoma and childhood germ cell tumors, Clin Biochem (2014), http://dx.doi.org/10.1016/j.clinbiochem.2014.05.035
Contents lists available at ScienceDirect
Clinical Biochemistry journal homepage: www.elsevier.com/locate/clinbiochem
Short Communication
Clinical relevance of AFP, its molecular variants and HCG in hepatoblastoma and childhood germ cell tumors Tangirala Malati Department of Biochemistry, Nizam's Institute of Medical Sciences, Hyderabad 500008, Andhra Pradesh, India
Summary Childhood cancers are the leading cause of death among children between infancy and age fifteen years. Of these, the pediatric germ cell tumors (GCTs) are a diverse group of neoplasms that account for approximately 3% of all childhood cancers. GCTs arise from primordial cells involved in gametogenesis, are relatively rare and often present as large tumors both in gonadal as well as at extra gonadal sites. Extra gonadal tumors are more common in neonates and infants, whereas tumors in gonads occur predominantly in childhood and adolescence. Pediatric GCTs include germinomas, non-seminomatous GCTs and teratomas [1]. Hepatoblastomas (HB) are very rare malignant neoplasms and account for about 1% of all pediatric tumors. These tumors originate in the liver and affect children from infancy to about 5 years of age. Pediatric liver tumors include hepatoblastoma, hepatocellular carcinoma, sarcoma, GCTs and rhabdoid tumors. The pediatric embryonal tumor HB accounts for 60% of malignant hepatic neoplasms [2]. Serum tumor markers offer great promise in the management of childhood malignancies and are integral to disease diagnosis and prediction of treatment response. Cancer biomarkers are substances that are expressed by malignant tissues, circulating tumor components or generated by the host in response to the tumor. These markers serve as essential tools to aid clinicians in diagnosis, staging and risk
assessments. The two clinically relevant tumor markers in pediatric oncology are the alpha-fetoprotein (AFP) and beta human chorionic gonadotropin (βHCG) [3]. Yolk sac AFP and liver AFP synthesized during fetal and adult lives are immunologically cross-reactive. They exhibit molecular heterogeneity with respect to charge, molecular size and lectin binding properties. The qualitative and quantitative estimations of molecular variants (lectin reactive and lectin non-reactive) of AFP highlighted the clinical relevance in differential diagnosis of AFP secreting tumors. The AFP variants as diagnostic aids also help in providing better management and prognosis. Lastly, a few follow-up case studies will be of help in establishing the importance of AFP and βHCG as diagnostic aid in monitoring the efficacy of cancer treatment and in predicting early tumor recurrence.
References [1] Mosbech CH, Rechnitzer C, Brok JS, Rajpert-De Meyts E, Hoei-Hansen CE. Recent advances in understanding the etiology and pathogenesis of pediatric germ cell tumors. Pediatr Hematol Oncol Feb 26, 2014;36:263–70. [2] Fabre M, Yilmaz F, Buendia MA. Hepatic tumors in childhood: experience on 245 tumors and review of literature. Ann Pathol 2004;24:536–55. [3] Schneider DT, Calaminus G, Göbel U. Diagnostic value of alpha 1-fetoprotein and betahuman chorionic gonadotropin in infancy and childhood. Pediatr Hematol Oncol 2001;18:11–26.
E-mail address: [email protected].
http://dx.doi.org/10.1016/j.clinbiochem.2014.05.035 0009-9120/© 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Please cite this article as: Malati T, Clinical relevance of AFP, its molecular variants and HCG in hepatoblastoma and childhood germ cell tumors, Clin Biochem (2014), http://dx.doi.org/10.1016/j.clinbiochem.2014.05.035
