Quantification of Alpha-Fetoprotein and Beta-HCG in Testis Tumor Patients

Dunzendorfer, U; Jurincic, C.

doi:10.1159/000281950

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…According to current guidelines, serum tumour markers are used to assist timely diagnosis of GCT, to accurately stage the disease, to assess the prognostic category of metastasized GCTs, to monitor treatment success, and finally to detect relapse during follow-up [5, 6]. bHCG is a 38 kDa glycoprotein produced by syncytiotrophoblastic giant cells mainly in chorionic carcinoma [7]. AFP is a 70 kDa glycoprotein produced by cells of the yolk sac tumour and rarely by embryonal carcinoma [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Serum Tumour Markers in Testicular Germ Cell Tumours: Frequencies of Elevated Levels and Extents of Marker Elevation Are Significantly Associated with Clinical Parameters and with Response to Treatment

Dieckmann

Simonsen-Richter

Kulejewski

et al. 2019

BioMed Research International

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Introduction. Although serum tumor markers beta human chorionic gonadotropin (bHCG), alpha-fetoprotein (AFP), and lactate dehydrogenase (LDH) are well-established tools for the management of testicular germ cell tumours (GCTs), there are only few data from contemporary cohorts of primary GCT patients regarding these biomarkers. Our aim was to evaluate marker elevations in testicular GCTs and to document their associations with various clinical characteristics.Patients and Methods. A total of 422 consecutive patients with GCTs were retrospectively analysed regarding serum levels of bHCG, AFP, and LDH during the course of treatment. Additionally, the following characteristics were recorded: histology, age, laterality, clinical stage (CS), pT-stage, and tumour size. Marker elevations were first tabulated in dichotomized way (elevated: yes/no) in various subgroups and second as continuous measured serum values. Descriptive statistical methods were employed to look for differences among subgroups and for associations of elevations with clinical parameters.Results. In all GCT patients, the frequencies of elevated levels of bHCG, AFP, LDH, and bHCG or AFP were 37.9%, 25.6%, 32.9%, and 47.6%; in pure seminomas 28%, 2.8%, 29.1%, and 30.3%; and in nonseminoma 53.0%, 60.1%, 38.7%, and 73.8%. Significant associations were noted with pT-stages >pT1, clinical stages >CS1, tumour size, and younger age. Frequencies of marker elevations dropped significantly after treatment, but LDH levels remained elevated in 30.5%-34.1%. Relapsing patients (n=27) had elevated levels of bHCG, AFP, and LDH in 25.9%, 22.2%, and 29.6%, respectively, thirteen of whom with a changed marker pattern.Conclusions. The classical GCT-biomarkers correlate with treatment success. Clinical utility is limited due to proportions of < 50% of patients with elevated levels and the low specificity of LDH. The elevation rates are significantly associated with histology, clinical and pT-stages, tumour size, and younger age. Individual marker patterns may change upon relapse. Clinically, ideal biomarkers are yet to be found.

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Section: Introductionmentioning

confidence: 99%

Serum Tumour Markers in Testicular Germ Cell Tumours: Frequencies of Elevated Levels and Extents of Marker Elevation Are Significantly Associated with Clinical Parameters and with Response to Treatment

Dieckmann

Simonsen-Richter

Kulejewski

et al. 2019

BioMed Research International

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hCG ET ses sous-unites comme marqueurs tumoraux

Feinstein

Akar

Blacker

et al. 1989

Journal of Steroid Biochemistry

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Testicular seminoma with human chorionic gonadotropin production

Hori

Uematsu

Yasoshima

et al. 1997

Pathology International

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Testicular seminoma with elevated serum human chorionic gonadotropin level (hCG-positive seminoma) is regarded as more malignant than marker-negative seminoma, although its prognosis is still unclear. To clarify the malignant potential of seminoma with hCG production, the serum levels of the beta subunit of hCG (beta-hCG) and lactic acid dehydrogenase (LDH) were examined in 35 and 40 patients, respectively, and the immunohistochemical expression of beta-hCG examined in 45 tumors. The elevation of the LDH serum level correlated to the invasive status, metastatic status and poor outcome, while that of the serum beta-hCG level correlated only to the metastatic status. Immunohistochemical expression of beta-hCG was observed in syncytiotrophoblastic giant cells in 11 tumors and a few mononuclear seminoma cells in 36 tumors. Expression was not associated with the malignancy potential, except where the expression in mononuclear cells inversely correlated to the invasive status. These results suggest that most seminomas produce a slight amount of hCG; that an elevated hCG serum level indicates the presence of metastatic tumors and mainly reflects an increase in tumor volume but not in cellular malignancy potential; and that the LDH serum level, rather than hCG, is more useful as a prognostic indicator for patients with seminoma.

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Quantification of Alpha-Fetoprotein and Beta-HCG in Testis Tumor Patients

Cited by 3 publications

References 8 publications

Serum Tumour Markers in Testicular Germ Cell Tumours: Frequencies of Elevated Levels and Extents of Marker Elevation Are Significantly Associated with Clinical Parameters and with Response to Treatment

Serum Tumour Markers in Testicular Germ Cell Tumours: Frequencies of Elevated Levels and Extents of Marker Elevation Are Significantly Associated with Clinical Parameters and with Response to Treatment

hCG ET ses sous-unites comme marqueurs tumoraux

Testicular seminoma with human chorionic gonadotropin production

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