Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors—Past, Present and Future

Abstract

Germ cell tumors (GCTs) are a heterogenous group of neoplasms in children and young adults, in which serum tumor markers have been demonstrated to be highly sensitive diagnostic and monitoring tools. The known "old" serum biomarkers, alpha-fetoprotein (AFP), human choriogonadotropin (β-hCG) and lactate dehydrogenase (LDH), have some limitations in sensitivity and specificity. MIRNAs from the miR-371~373 (chromosomal locus 19q13.41) and miR-302/367 (4q25) clusters are universally over-expressed in malignant GCT tissue samples. The levels of miRNAs from these clusters are elevated in the serum. They seem to be highly sensitive and specific in malignant GCTs diagnosis and disease assessment during treatment and follow-up. The aim of our review was to present the role of serum tumor markers in the clinical staging, treatment monitoring and follow-up of pediatric patients with GCTs and show new possibilities. The serum levels of miRNAs seem to be a new, promising essential tool in the clinical management of GCTs.

A Comprehensive Review of Current Trends in the Diagnosis and Treatment of Ovarian Germ Cell Tumors

“…A decrease in these marker levels during chemotherapy is typically associated with a positive response, while rising or persistent elevated levels may indicate resistance or disease progression. Continually monitoring these markers allows healthcare providers to make real-time treatment adjustments, optimizing the patient's chances of a successful outcome [ 39 ].…”

Role of Alpha-Fetoprotein (AFP) in Diagnosing Childhood Cancers and Genetic-Related Chronic Diseases

“…These microRNAs are short single-stranded fragments of noncoding RNA responsible for regulating gene expression by influencing translation blocking or mRNA degradation. Alterations in microRNA expression contribute to the initiation of carcinogenesis [66]. In terms of diagnosis and recurrence monitoring, miRNA demonstrates higher specificity (93.4%) and sensitivity (88.7%) compared to AFP, regardless of the histopathological type, patient age, or anatomical location of the tumor [57,67,68].…”

Manifestations of Ovarian Cancer in Relation to Other Pelvic Diseases by MRI

“…Histological types include teratoma (mature, immature, and monodermal), dysgerminoma, yolk sac tumor (also known as endodermal sinus tumor), embryonal carcinoma, polyembryoma, and choriocarcinoma. The vast majority of these tumors (95%) are benign; in a number of cases germ cell tumors may be associated with elevated tumor markers including human chorionic gonadotropin (HCG), alfa-fetoprotein (AFP), and the recently introduced embryonic serum microRNAs (MiRNA), which helps in the diagnosis and monitoring of such tumors [ 92 ].…”