Department of Urology, Columbia University Medical Center, Herbert Irving Pavilion, 11th Floor 161 Fort Washington Avenue, New York, NY 10032, USA.
Nat Rev Urol. 2010 Nov;7(11):610-7. doi: 10.1038/nrurol.2010.166.
Serum tumor markers play a critical role in the diagnosis, staging, risk stratification, and surveillance of patients with testicular germ cell tumors (GCTs). Production of the oncofetal substances α fetoprotein and human chorionic gonadotropin can aid the diagnosis of testicular GCTs, and specific patterns of marker elevation can be used to determine the type of tumor, particularly as it pertains to nonseminoma. These markers, in addition to lactate dehydrogenase, have been incorporated in the standard TNM staging system for testicular tumors; the S stage category corresponds to serum elevation of these proteins. Furthermore, the degree of serum tumor marker elevation has been incorporated into standardized patient risk groupings, which are used to guide therapeutic management. The rate of tumor marker decay after radical orchiectomy is an important index to monitor, as a slow decline might be indicative of metastatic disease and should prompt a thorough systemic survey. The rate of tumor marker decline is already being utilized in the setting of metastatic GCTs to determine response to chemotherapy, and has been used in some scenarios to individualize the type of chemotherapy patients received. Compared to any other solid organ malignancy, the role of serum tumor markers in GCT is unprecedented; these markers are instrumental in the diagnosis and management of testicular GCT.
血清肿瘤标志物在睾丸生殖细胞肿瘤（GCT）患者的诊断、分期、风险分层和监测中起着至关重要的作用。癌胚物质α-胎蛋白和人绒毛膜促性腺激素的产生有助于睾丸 GCT 的诊断，并且标志物升高的特定模式可用于确定肿瘤的类型，尤其是对于非精原细胞瘤。这些标志物与乳酸脱氢酶一起被纳入睾丸肿瘤的标准 TNM 分期系统；S 期类别对应于这些蛋白的血清升高。此外，血清肿瘤标志物升高的程度已被纳入标准化患者风险分组中，用于指导治疗管理。根治性睾丸切除术（radical orchiectomy）后肿瘤标志物的下降速度是一个重要的监测指标，因为下降缓慢可能表明存在转移疾病，并应促使进行全面的系统检查。肿瘤标志物下降的速度已经在转移性 GCT 中用于确定对化疗的反应，并已在某些情况下用于个性化患者接受的化疗类型。与任何其他实体器官恶性肿瘤相比，血清肿瘤标志物在 GCT 中的作用是前所未有的；这些标志物在睾丸 GCT 的诊断和管理中具有重要作用。
