Oncology Division, University College London Hospitals NHS Foundation Trust, London, UK; National Cancer Research Institute Teenage and Young Adult and Germ Cell Research Group, London, UK.
Department of Medical Oncology, St Bartholomew's Hospital, London, UK.
Clin Genitourin Cancer. 2021 Oct;19(5):381-387. doi: 10.1016/j.clgc.2021.03.005. Epub 2021 Mar 17.
MicroRNAs from the miR-371~373 and miR-302/367 clusters, particularly miR-371a-3p, are promising biomarkers for blood-based diagnosis and disease monitoring of malignant germ cell tumors (GCTs) and are nearing clinical implementation. These biomarkers have superior sensitivity and specificity compared with current markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). We explored patient acceptability of using circulating microRNAs to replace multiple serial computed tomography (CT) scans in malignant GCT follow-up.
Two workshops involved interactive presentations and focus groups. Discussions were digitally recorded and transcribed verbatim. Qualitative thematic analysis of transcripts identified the key themes.
Prior to the workshops, potential participants expressed concern about the adoption of new blood tests due to personal experiences of the limitations of existing (AFP/HCG) markers. Twelve males (22-57 years of age; currently, 26-59 years of age) with a malignant GCT diagnosis participated; all were in follow-up. Three had experienced recurrence. Participants had cumulative exposure of between 1 and 15 CT scans. Data saturation was reached at the second workshop; five themes emerged underpinning preference for microRNA testing versus CT scans: (1) increased sensitivity and safety, (2) reduced financial costs, (3) reduced time for testing and results, (4) practicalities, and (5) reduced anxiety. However, some participants perceived an increased diagnostic capacity of CT scans versus blood testing.
This first user consultation of circulating microRNA testing for future malignant GCT follow-up suggests high acceptability with potential patient and healthcare system benefits.
miR-371~373 和 miR-302/367 簇中的 microRNAs，尤其是 miR-371a-3p，是恶性生殖细胞肿瘤（GCT）基于血液的诊断和疾病监测的有前途的生物标志物，并且即将临床应用。与当前的标志物甲胎蛋白（AFP）和人绒毛膜促性腺激素（HCG）相比，这些生物标志物具有更高的灵敏度和特异性。我们探讨了使用循环 microRNAs 替代恶性 GCT 随访中的多个连续计算机断层扫描（CT）扫描的患者可接受性。
两个研讨会涉及互动演示和焦点小组。讨论内容被数字记录并逐字转录。对记录的文字记录进行定性主题分析，确定了关键主题。
在研讨会之前，潜在参与者对采用新的血液检测表示担忧，因为他们个人经历了现有（AFP/HCG）标志物的局限性。12 名男性（22-57 岁；目前 26-59 岁）患有恶性 GCT 诊断；均在随访中。有 3 人经历过复发。参与者的 CT 扫描累计暴露量为 1 至 15 次。第二次研讨会达到数据饱和；出现了五个主题，为 microRNA 检测与 CT 扫描的偏好提供了依据：（1）增加的敏感性和安全性，（2）降低的财务成本，（3）减少检测和结果的时间，（4）实用性，（5）降低焦虑。然而，一些参与者认为 CT 扫描比血液检测具有更高的诊断能力。
这是首次对未来恶性 GCT 随访中循环 microRNA 检测进行的用户咨询，表明其具有很高的可接受性，可能对患者和医疗保健系统有益。
