Tumor Markers and Pediatric Intraabdominal Solid Tumors
Keywords:
Tumor markers, intraabdominal solid tumorsAbstract
Background: There are many tumor markers for initial investigation and diagnosis of pediatric intraabdominal solid tumors (ISTs). However, some types of ISTs cannot be diagnosed by tumor marker examinations because of no specific relationship between the tumor markers and these ISTs.
Purpose: The aim of this study was to analyse the relationships between tumor markers and pediatric ISTs.
Materials and Methods: A retrospective study of patients with ISTs who were initially treated at Queen Sirikit National Institute of Child Health form June 2015 to December 2016 was conducted. Patient data were collected from the medical records and were selected only among those with the definite diagnosis of ISTs. Tumor markers included neuron-specific enolase (NSE), 24-hour urine of vanillymandelic acid (VMA), serum ferritin, lactase dehydrogenase (LDH), serum alpha-fetoprotein (AFP), betahuman chorionic gonadotrophin (beta-hCG) and cancer antigen 125 (CA125). Information of the tumor markers and each type of ISTs were studied in order to demonstrate the relationships by using statistical analysis with SPSS program. The level of p-value less than 0.05 was considered significant.
Results: Thirty-six patients with ISTs were available for the study. The ISTs were finally definite diagnosis based on pathological reports including neuroblastoma, hepatoblastoma, hematologic tumors and retroperitoneal teratoma in 12 (33.3%), 6 (16.7%), 5 (13.9%) and 4 (11.1%), respectively. The 9 remaining ISTs were Wilms’ tumor (3), ovarian dysgerminoma (2) and others (4). NSE over 130 ng/ml and urine VMA over 2 mg/day were statistically significant for definite diagnosis of neuroblastoma (p = 0.033, 0.034). NSE level might elevate in ovarian dysgerminoma, Wilms’ tumor, lymphoma and leukemia but it was not statistically significant (p > 0.05). Increased NSE, 24-hour urine VMA and serum ferritin levels demonstrated a relationship to the severity of neuroblastoma both advanced stage and poor prognosis but no statistical significance. An elevation of LDH level might be found in many ISTs, but it revealed a significant relationship to ovarian dysgerminoma and N-myc amplification of neuroblastoma. High level of beta-hCG and CA 125 were observed in ovarian dysgerminoma. Marked elevation of average AFP level of 653,538 ng/ml was strongly indicated in diagnosis of hepatoblastoma (p = 0.01).
Conclusion: NSE over 130 ng/ml and urine VMA over 2 mg/day had a significant relationship to diagnosis of neuroblastoma. Marked elevation of LDH level was significantly demonstrated N-myc amplification of neuroblastoma and ovarian dysgerminoma. Marked elevation of AFP level was a strong indicator for diagnosis of hepatoblastoma in pediatric patient with ISTs.
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