Abstract：
BACKGROUND: Serum alpha-fetoprotein (AFP) is often used as tumour marker for recurrent sacrococcygeal teratoma (SCT). We aimed to assess the normal dynamics of serum AFP levels after initial resection and diagnostic accuracy of serum AFP levels the follow-up for recurrence in SCT.
METHODS: This retrospective study included 57 patients treated for SCT in the six pediatric surgical centers in the Netherlands from 1980 to 2018.
RESULTS: 57 patients were included in the study of whom 19 children developed 20 recurrences at a median of 14.0 months after initial resection. No significant difference was found in serum AFP level dynamics between the recurrence and non-recurrence group after initial resection (p = 0.950). Serum AFP levels did not significantly increase before recurrence (p = 0.106) compared to serum AFP levels of children without recurrence at the same time. However, serum AFP levels did significantly increase in malignant recurrences (n = 7) (p = 0.03) compared to patients without recurrence. A cut-off value of 55 μg/L was found to be predictive for recurrent SCT with an Area Under the Curve (AUC) of 0.636 with sensitivity of 50% and specificity of 100%.
CONCLUSIONS: Dynamics of serum AFP levels are not different between patients with and without recurrence after initial resection of SCT. Serum AFP levels are not predictive for mature or immature recurrent SCT and normal AFP levels do not rule out recurrent SCT. However, serum AFP levels exceeding 55 μg/L can indicate recurrent SCT, especially malignant recurrences.
METHODS: This retrospective study included 57 patients treated for SCT in the six pediatric surgical centers in the Netherlands from 1980 to 2018.
RESULTS: 57 patients were included in the study of whom 19 children developed 20 recurrences at a median of 14.0 months after initial resection. No significant difference was found in serum AFP level dynamics between the recurrence and non-recurrence group after initial resection (p = 0.950). Serum AFP levels did not significantly increase before recurrence (p = 0.106) compared to serum AFP levels of children without recurrence at the same time. However, serum AFP levels did significantly increase in malignant recurrences (n = 7) (p = 0.03) compared to patients without recurrence. A cut-off value of 55 μg/L was found to be predictive for recurrent SCT with an Area Under the Curve (AUC) of 0.636 with sensitivity of 50% and specificity of 100%.
CONCLUSIONS: Dynamics of serum AFP levels are not different between patients with and without recurrence after initial resection of SCT. Serum AFP levels are not predictive for mature or immature recurrent SCT and normal AFP levels do not rule out recurrent SCT. However, serum AFP levels exceeding 55 μg/L can indicate recurrent SCT, especially malignant recurrences.
摘要：
背景：血清甲胎蛋白（AFP）通常用作复发性骶尾部畸胎瘤（SCT）的肿瘤标志物。我们旨在评估初次切除后血清AFP水平的正常动态以及对SCT复发的随访中血清AFP水平的诊断准确性。
方法：这项回顾性研究包括1980年至2018年在荷兰六个儿科外科中心接受SCT治疗的57例患者。
结果：57例患者被纳入研究，其中19名儿童在初次切除后中位数为14.0个月时复发20例。初次切除后复发组和非复发组之间的血清AFP水平动态没有显着差异（p=0.950）。与同时无复发儿童的血清AFP水平相比，复发前血清AFP水平没有显着增加（p=0.106）。然而,与无复发患者相比,恶性复发患者血清AFP水平显著升高(n=7)(p=0.03).发现55μg/L的截止值可预测具有0.636的曲线下面积(AUC)的复发性SCT,灵敏度为50%,特异性为100%。
结论：SCT初次切除后有复发和无复发的患者血清AFP水平动态没有差异。血清AFP水平不能预测成熟或未成熟的复发性SCT，正常的AFP水平不能排除复发性SCT。然而,血清AFP水平超过55μg/L可提示SCT复发，尤其是恶性复发.
方法：这项回顾性研究包括1980年至2018年在荷兰六个儿科外科中心接受SCT治疗的57例患者。
结果：57例患者被纳入研究，其中19名儿童在初次切除后中位数为14.0个月时复发20例。初次切除后复发组和非复发组之间的血清AFP水平动态没有显着差异（p=0.950）。与同时无复发儿童的血清AFP水平相比，复发前血清AFP水平没有显着增加（p=0.106）。然而,与无复发患者相比,恶性复发患者血清AFP水平显著升高(n=7)(p=0.03).发现55μg/L的截止值可预测具有0.636的曲线下面积(AUC)的复发性SCT,灵敏度为50%,特异性为100%。
结论：SCT初次切除后有复发和无复发的患者血清AFP水平动态没有差异。血清AFP水平不能预测成熟或未成熟的复发性SCT，正常的AFP水平不能排除复发性SCT。然而,血清AFP水平超过55μg/L可提示SCT复发，尤其是恶性复发.
