Pineal region germ cell tumors are a heterogenous group of tumors; of these, pure germinoma shows high sensitivity to adjuvant therapy, and the timing and sequence of surgical intervention and adjuvant/neoadjuvant therapy are important for devising a treatment strategy for intracranial germ cell tumors (IGCT). Biopsy is diagnostically useful, but is often insufficient because only a limited amount of specimen can be obtained. In the present study, we aimed to determine the value of cerebrospinal fluid placental alkaline phosphatase (PLAP) levels, reflecting the presence of germinoma, as a reliable indicator to determine treatment strategies for pineal germ cell tumors. To assess the relationship between elevated PLAP levels and the presence of germinoma, we retrospectively reviewed histopathological findings of 25 surgical cases of IGCT in the pineal region. The PLAP value reflects the existence of a germinoma component within a total tumor volume; consequently, tumor volume could be reduced in cases with elevated PLAP, while tumors negative for PLAP did not decrease in size. Therefore, PLAP levels may help neurosurgeons optimize surgical intervention timing for teratomas in the pineal region.

中文翻译：

---

脑脊液中的胎盘碱性磷酸酶作为生物标记物，用于优化松果体区域生殖细胞肿瘤的外科治疗策略。

松果区生殖细胞肿瘤是一组异质性肿瘤。其中，纯种生殖细胞瘤对辅助治疗具有很高的敏感性，外科干预和辅助/新辅助治疗的时机和顺序对于制定颅内生殖细胞肿瘤（IGCT）的治疗策略很重要。活检在诊断上是有用的，但由于只能获得有限的标本，因此常常不足。在本研究中，我们旨在确定反映发芽瘤存在的脑脊液胎盘碱性磷酸酶（PLAP）水平的价值，作为确定松果生殖细胞肿瘤治疗策略的可靠指标。为了评估PLAP水平升高与生殖细胞瘤的存在之间的关系，我们回顾性回顾了松果体区25例IGCT手术病例的组织病理学发现。PLAP值反映了在总的肿瘤体积中存在生殖器官成分。因此，在PLAP升高的情况下，肿瘤体积可以减少，而PLAP阴性的肿瘤的大小并没有减少。因此，PLAP水平可能有助于神经外科医师优化松果体区域畸胎瘤的手术干预时机。