Testicular germ cell tumors(GCTs)are malignancies that can be histologically distinguished as seminomatous testicular germ cell tumors(SGCTs)or nonseminomatous testicular germ cell tumors(NSGCTs).The primary treatment...Testicular germ cell tumors(GCTs)are malignancies that can be histologically distinguished as seminomatous testicular germ cell tumors(SGCTs)or nonseminomatous testicular germ cell tumors(NSGCTs).The primary treatment of testicular GCTs is orchiectomy which can be followed with adjuvant radiotherapy,platinum-based chemotherapeutics,and/or retroperitoneal lymph node dissection(RPLND)based on clinical staging of disease and patient risk stratification[1].The measurement of serum tumor markers(STMs)is integral to the diagnosis and monitoring of GCTs[2].Currently,three STMs are used for clinical monitoring:Alpha-fetoprotein(AFP),human chorionic gonadotrophin(hCG),and lactate dehydrogenase(LDH).However,conventional STMs offer limited performance characteristics due to only being elevated in<60%of GCTcases with sensitivity being especially poor in the case of occult disease and certain GCT subtypes,i.e.seminoma and teratoma[3].There remains a need to improve current diagnostic approaches to avoid subjecting patients to the side effects of over-or under-treatment[4].Further,STM elevation can be associated with variables unrelated to GCTs such as liver disease and hypogonadism[5].These limitations have engendered the need to identify additional blood-based biomarkers that offer superior performance in clinical scenarios where STMs have fallen short.展开更多
文摘Testicular germ cell tumors(GCTs)are malignancies that can be histologically distinguished as seminomatous testicular germ cell tumors(SGCTs)or nonseminomatous testicular germ cell tumors(NSGCTs).The primary treatment of testicular GCTs is orchiectomy which can be followed with adjuvant radiotherapy,platinum-based chemotherapeutics,and/or retroperitoneal lymph node dissection(RPLND)based on clinical staging of disease and patient risk stratification[1].The measurement of serum tumor markers(STMs)is integral to the diagnosis and monitoring of GCTs[2].Currently,three STMs are used for clinical monitoring:Alpha-fetoprotein(AFP),human chorionic gonadotrophin(hCG),and lactate dehydrogenase(LDH).However,conventional STMs offer limited performance characteristics due to only being elevated in<60%of GCTcases with sensitivity being especially poor in the case of occult disease and certain GCT subtypes,i.e.seminoma and teratoma[3].There remains a need to improve current diagnostic approaches to avoid subjecting patients to the side effects of over-or under-treatment[4].Further,STM elevation can be associated with variables unrelated to GCTs such as liver disease and hypogonadism[5].These limitations have engendered the need to identify additional blood-based biomarkers that offer superior performance in clinical scenarios where STMs have fallen short.