A Retrospective Study Of Ratio Of Serum AFP In Infant Teratomas

Objective: To investigate the clinical significance of changes and influence factors of serum AFP in neonatus and infants and the ratio of normal reference value in different characters teratomas.Method:The date of 166 infants with teratomas,who were treated in Children 'hospital of Chongqing Medical University ,from October 1991 to May 2010 were retrospectively analyzed.The data of readimision or giving up treatment or older than one year old was removed.We considerd that pathologic biopsy was the only standard to diagnose nature of benign and malignant teratomas and the determination of serum AFP was quantitative. The ratio of serum AFP was that determined values compared with upper limit of normal reference values. The possible factors which were affected positive rate of serum AFP was Univariate analysised and statistical software SPSS 18.0was used to process data.Result: (1)general data:Among the 166 cases,31were neonatus(18.67%) and 135 were infants. The study population consisted of 64 boys and 102 girls (boys:grils=1:1.59),with a age range 3 hours to 11.5months old. 95 of them came from country while 71 of them came from city.(2)131 were diagnosed as mature teratomas,while 22 were malignant teratomas,13 were immature teratomas.The positive rate of serum AFP in mature teratomas, immature teratomas and malignant teratomas were 44.28%(58/131), 92.31%( 12/13) , 100% ( 13/13 ),respectively. The maximum serum AFP ratio was 16.34 (absolute value 670ng/ml,mean age 3.4 monthes) in mature teratomas, and The miximum serum AFP ratio was 83.17(absolute value 499ng/ml,mean age 7.6 monthes).Moreover, serum AFP in immature teratomas had significant difference.(3)The factors affecting positive rate of serum AFP: We compared positive rate of serum AFP between different groups. There were statistically significant difference between mature teratomas and immature teratomas groups(P<0.05) ,mature teratomas and malignant teratomas groups (P<0.05). We found no significant differences between immature teratomas and malignant teratomas groups(P>0.05).There were no significant differences between different sexs or residences groups(P>0.05), while difference between different ages or incidence locations were statistically significant(P<0.05).Conclusion: (1) The reason of mature teratoma with ratio of serum AFP elevated may be related to infant physiology of increased ,hepatic injury and limitations of biopsy.(2) When serum AFP ratio is less than 16,it should be diagnosised as mature teratoma first before operation. While serum AFP ratio is higher than 86, it should highly regarded as malignant teratoma. The scope of serum AFP ratio changes largely in immature teratoma,we should take other more tests to diagnose it.(3)characters of teratomas, ages and tumor invasive sites were significantly associated with Positive rate of serum AFP, but sexs or residences seemed no related with Positive rate of serum AFP.