Dieckmann Klaus-Peter, Klemke Markus, Grobelny Francesca, Radtke Arlo, Dralle-Filiz Inken, Wülfing Christian, Belge Gazanfer
Department of Urology, Asklepios Klinik Altona, Hamburg, Germany.
Department of Urology, Albertinen Krankenhaus, Hamburg, Germany.
Front Oncol. 2022 May 6;12:889624. doi: 10.3389/fonc.2022.889624. eCollection 2022.
Radiological evaluation of postchemotherapy residual masses of metastatic seminoma is characterized by poor diagnostic accuracy. Serum levels of microRNA-371a-3p (M371) involve high specificity and sensitivity for the primary diagnosis of seminoma. We evaluated if M371 levels can indicate the presence of vital disease in postchemotherapy residual masses in patients with metastatic seminoma.
Twenty-three seminoma patients (median age 52 years) with residual masses had posttreatment measurements of serum M371 levels (group A), fourteen of whom had measurements also beforehand. The posttreatment results were compared with the clinical outcome during follow-up. Eleven patients with complete remission after treatment of metastatic seminoma (group B) and 33 men with non-malignant testicular diseases (group C) served as controls. M371 serum levels were measured by quantitative real-time PCR using miR-30b-5p as endogenous control. An evaluation was performed with descriptive statistical methods.
Twenty-two patients of Group A had uneventful follow-up so far, twenty-one of whom had M371 level <5, and one other had a mildly elevated level below relative quantity (RQ) = 10. One patient with a level of RQ = 26.2 rapidly progressed. The median posttreatment M371 level of the non-progressing patients of group A is not significantly different from the median level of the control group with complete remission (B). Before treatment, the median M371 levels in groups A and B were 507.6 and 143.9, respectively. In both groups, significant drops in M371 levels resulted from treatment.
Normal M371 serum levels at the time of completion of treatment of metastatic seminoma indicate the absence of vital seminoma in residual masses, while elevated levels >RQ = 10 predict the presence of disease. The optimal timing of M371 measurement after chemotherapy and the appropriate cutoff level still need to be determined. Based on the present results, measuring serum M371 levels involves the potential of a novel tool for assessing postchemotherapy residual masses of metastatic seminoma.
转移性精原细胞瘤化疗后残留肿块的放射学评估诊断准确性较差。血清微小RNA-371a-3p(M371)水平对精原细胞瘤的初步诊断具有较高的特异性和敏感性。我们评估了M371水平是否可指示转移性精原细胞瘤患者化疗后残留肿块中是否存在活性疾病。
23例有残留肿块的精原细胞瘤患者(中位年龄52岁)在治疗后测量了血清M371水平(A组),其中14例患者在治疗前也进行了测量。将治疗后的结果与随访期间的临床结局进行比较。11例转移性精原细胞瘤治疗后完全缓解的患者(B组)和33例患有非恶性睾丸疾病的男性(C组)作为对照。以miR-30b-5p为内参,通过定量实时PCR检测血清M371水平。采用描述性统计方法进行评估。
A组22例患者目前随访情况良好,其中21例M371水平<5,另1例轻度升高,相对定量(RQ)<10。1例RQ = 26.2的患者病情迅速进展。A组病情未进展患者治疗后的M371水平中位数与完全缓解的对照组(B组)中位数无显著差异。治疗前,A组和B组的M371水平中位数分别为507.6和143.9。两组治疗后M371水平均显著下降。
转移性精原细胞瘤治疗结束时血清M371水平正常表明残留肿块中不存在活性精原细胞瘤,而水平> RQ = 10升高则预示疾病存在。化疗后M371测量的最佳时间和合适的临界值仍需确定。基于目前的结果,检测血清M371水平可能成为评估转移性精原细胞瘤化疗后残留肿块的一种新工具。