Carcinoembryonic antigen (CEA),
alpha-fetoprotein (AFP),
placental alkaline phosphatase (ALP4),
human chorionic gonadotropin (
HCG), human chorionic gonadotropin-beta-subunit (beta-HCG) and
human placental lactogen (HPL) were simultaneously and serially determined in the sera of the patients with ovarian
carcinoma. The incidence of patients whose tests for carcinoembryonic
proteins were positive was as follows: CEA, 29/55 (56.4%); AFP, 7/58 (13.5%); ALP4, 3/47 (6.4%); HCG, 20/50 (40%); beta-HCG, 13/50 (26%); HPL, 0. Determination of CEA in serum was considered to be a useful test for screening ovarian
carcinoma and for follow-up studies, especially for so-called
mucin-producing
tumors (
mucinous cystadenocarcinoma,
Krukenberg's tumor, and
pseudomyxoma peritonei). The specificity of AFP to ovarian
carcinoma, especially in
tumors of germ cell origin, seemed to be very high, thus AFP can be an extremely effective means for the diagnosis and the prognosis of patients with ovarian
tumors arising from germ cells. But pure
dysgerminoma, which was not positive in AFP, showed relatively high levels beta-HCG preoperatively, and its
clinical course was associated with serial beta-HCG assay. There was no
tumor specificity in positive HCG. ALP4 seemed to have little clinical significance because the detection was infrequent.