[CEA, HCG-beta and alpha fetoproteins - clinical significance as tumor markers]

Representation of the clinical significance of the tumor markers CEA, HCG-beta and alpha 1-fetoprotein (AFP) of the basis of the relevant literature and of own studies. As a marker for tumors of the urogenital tract, CEA is at present of very little value as it is too unspecific. HCG-beta and AFP, on the other hand, are important new parameters for both the demonstration of so-called subclinical metastases (staging) and clinical case control, particularly with malignant nonseminomatous tumors of the testicles. Over a period of four years we found in 62 out of 85 patients with nonseminomatous testicle tumors that -- in accordance with the literature -- simultaneous determination by the two markers (85% positive) is decidedly superior to the determination by one marker only. Out of 23 patients with a histologically classified seminoma, one patient (i.e. 4.4%) was HCG-beta positive. So far, the prognostic significance of such findings has generally not been clarified. It is shown here that exclusively "marker-oriented" therapy planning and case control without the clinical examination methods used so far are not yet justified because of the inadequate specificity and sensitivity of these two markers as well as of more recent ones (SP-1, TPA). Nevertheless, HCG-beta and AFP are at present important new methods in the areas of diagnosis (staging), therapy planning and case control as primarily increased marker values, or marker values increased during or after therapy clearly indicate metastasizing or renewed tumor activity, respectively.