Department of Urology, Konya City Hospital, Konya, Turkey.
Department of Urology, School of Meram Medicine, Necmettin Erbakan University, Konya, Turkey.
Urol J. 2024 Jun 9;21(4):242-249. doi: 10.22037/uj.v20i.8002.
We aimed to evaluate the diagnostic sensitivity and specificity of the miRNA-371a-3p for the primary diagnosis of germ cell tumors (GCT) and to investigate its relationship with pathological factors and clinical stage in the Turkish population.
In this prospective study, a total of 60 patients with GCTs, and 40 healthy male controls were examined for serum levels of miRNA-371a-3p before orchiectomy and again two weeks after surgery. The miRNA-371a-3p, alpha-fetoprotein (AFP), and beta-human chorionic gonadotropin (bHCG) levels in the preoperative and postoperative periods were compared at different clinical stages. Receiver operating characteristics curve analyses were performed to determine the sensitivity and specificity of miRNA-371a-3p. Clinical and pathological factors such as clinical stage (CS), tumor size, histology, rete testis invasion, and lymphovascular invasion, potentially impacting miRNA-371a-3p expression levels (relative quantity, RQ), were evaluated statistically.
The sensitivity of miR-371a-3p in GCT patients was 98.3%, and the specificity was 95% (AUC = 0.997 [95%Cl:0.99-1], p < .001). miR-371a-3p expression was not detected in two patients with teratoma. The median miR-371a-3p RQ was 489 times in GCT and 2.2 times in the Control group (p < .001). In the postoperative period, there was a significant decrease in AFP and bHCG levels in all CS-1 (p = .01) and 30% of the other CS (p = .3). Throughout this time there was a decrease of 19 times at the miR-371a-3p RQ in CS-1(p < .001) and 1.6 times in the other CS (p < .001). The miR-371a-3p RQs were correlated with tumor size and CS.
The miR-371a-3p seems to have higher diagnostic accuracy than classical serum tumor markers in GCT.
我们旨在评估 miRNA-371a-3p 对原发性生殖细胞肿瘤（GCT）的诊断敏感性和特异性，并在土耳其人群中研究其与病理因素和临床分期的关系。
在这项前瞻性研究中，共检查了 60 例 GCT 患者和 40 例健康男性对照者的血清 miRNA-371a-3p 水平，在睾丸切除术之前和术后两周进行检查。比较了不同临床分期的术前和术后 miRNA-371a-3p、甲胎蛋白（AFP）和β-人绒毛膜促性腺激素（bHCG）水平。进行受试者工作特征曲线分析以确定 miRNA-371a-3p 的敏感性和特异性。统计评估了可能影响 miRNA-371a-3p 表达水平（相对数量，RQ）的临床和病理因素，如临床分期（CS）、肿瘤大小、组织学、 rete 测试入侵和血管淋巴管侵犯。
miR-371a-3p 在 GCT 患者中的敏感性为 98.3%，特异性为 95%（AUC=0.997[95%Cl：0.99-1]，p<.001）。在两名畸胎瘤患者中未检测到 miR-371a-3p 表达。GCT 组的中位数 miR-371a-3p RQ 为 489 倍，对照组为 2.2 倍（p<.001）。在术后期间，所有 CS-1（p=0.01）和其他 30%CS（p=0.3）的 AFP 和 bHCG 水平均显著降低。在此期间，CS-1 中 miR-371a-3p RQ 降低了 19 倍（p<.001），其他 CS 中降低了 1.6 倍（p<.001）。miR-371a-3p RQ 与肿瘤大小和 CS 相关。
miR-371a-3p 在 GCT 中的诊断准确性似乎高于经典的血清肿瘤标志物。
