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70 NEW TUMOR MARKERS IN CHILDHOOD CANCER

Urinary cathecolamines and NSE are generally used tumor markers in children with neuroblastoma, AFP in those with hepatoblastoma, and AFP and hCG in patients with yolk sac tumor (YST). Virtually nothing is known about the new generation of markers, based on monoclonal antibodies, in these patients. We have explored the combined use of marker analysis 1) in patients with YST, and 2) in those with solid tumors and leukemias. We have compared previously documented tumor markers with the new ones in different patient groups.Sera from 11 patients with malignant YST were serially determined for AFP, hCG, SP1, CA 19-9 and CA 125. At diagnosis, AFP was elevated in 8/11 and placental protein (hCG/SPl) in 4/7 patients. The concentrations normalized after successful treatment. In two cases, a benign sacrococcygeal teratoma was operated in a newborn and the AFP level decreased; these patients later developed a malignant pelvic YST, and an elevation of the AFP level (and SP1 in one case) was noted. The CA 19-9 and/or CA 125 were elevated in 1/1 patient with malignant ovarian YST, and also in 2/2 patients with benign ovarian teratomas. Occasionally, elevated levels of the CA 19-9, CA 125, AFP and/or SP1 were seen in patients with leukemia (8/32), MDS (0/2), solid tumors (11/52) and various benign tumors (1/7). The clinical significance of these results remains to be evaluated.