Alpha-feto protein (AFP) and HCG are elevated, either singly or in combination, in more than 80% of patients with disseminated non-seminomatous germ cell tumours (NSGCT) and in about 60% of patients with stage 1 disease prior to orchidectomy. Another marker useful in patients with germ cell tumours is lactate dehydrogenase (LDH). Placental alkaline phosphatase (PLAP), although elevated in about 50% of patients with seminomas, is also raised by cigarette smoking, and adds little to clinical management.
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