Schoch Justine, Schmelz Hans, Dieckmann Klaus-Peter, Nestler Tim
Klinik für Urologie, Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Germany.
Urologie, Asklepios Klinik Altona, Hamburg, Germany.
Aktuelle Urol. 2024 Dec;55(6):520-527. doi: 10.1055/a-2422-0354. Epub 2024 Oct 23.
Germ cell tumors of the testis are the most common tumor entities in young men. Since the introduction of platinum-based chemotherapy in the 1970s, most patients can be cured despite the aggressiveness of germ cell tumors. Optimal serum tumor markers are required for diagnostics, therapy monitoring and aftercare, and these are subject to high requirements. The conventional testicular tumor markers human chorionic gonadotropin (hCG), alpha fetoprotein (AFP) and lactate dehydrogenase (LDH) only meet these requirements with insufficient sensitivity (30-70%). The markers investigated in recent decades, such as PLAP, CEA and NSE, have not become established. Currently, miRNA-371 is being researched in particular. Reliable findings are available for initial staging with significantly better specificities of miRNA-371 compared to conventional tumor markers. Further prospective studies are being conducted for other possible clinical applications, such as follow-up care, therapy monitoring or residual tumors, in order to investigate the revolutionary potential of miRNA-371 in these areas as well. Research is also currently being conducted on circulating tumor cells (CTCs) and cell-free DNA (cfNA) in various areas of application. With regard to germ cell tumors of the testis, however, these analyses are still in their infancy, but it is hoped that this will provide a further sufficient opportunity to use serum tumor markers.
睾丸生殖细胞肿瘤是年轻男性中最常见的肿瘤类型。自20世纪70年代引入铂类化疗以来,尽管生殖细胞肿瘤具有侵袭性,但大多数患者仍可治愈。诊断、治疗监测和后续护理需要最佳的血清肿瘤标志物,而这些标志物有很高的要求。传统的睾丸肿瘤标志物人绒毛膜促性腺激素(hCG)、甲胎蛋白(AFP)和乳酸脱氢酶(LDH)仅以不足的敏感性(30-70%)满足这些要求。近几十年来研究的标志物,如胎盘碱性磷酸酶(PLAP)、癌胚抗原(CEA)和神经元特异性烯醇化酶(NSE)尚未得到确立。目前,尤其在研究miRNA-371。与传统肿瘤标志物相比,miRNA-371在初始分期方面有可靠的发现,其特异性明显更好。正在针对其他可能的临床应用开展进一步的前瞻性研究,如随访、治疗监测或残留肿瘤,以便也研究miRNA-371在这些领域的革命性潜力。目前在各种应用领域也在对循环肿瘤细胞(CTC)和游离DNA(cfNA)进行研究。然而,对于睾丸生殖细胞肿瘤,这些分析仍处于起步阶段,但希望这将为使用血清肿瘤标志物提供进一步充分的机会。