The search for biomarkers of metastatic seminoma
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The search for biomarkers of metastatic seminoma. / Ruf, Christian G; Khalili-Harbi, N; Sachs, S; Isbarn, H; Wagner, W; Matthies, C; Meineke, V; Fisch, M; Chun, F K; Abend, M.
In: J UROLOGY, Vol. 190, No. 3, 01.09.2013, p. 1046-51.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The search for biomarkers of metastatic seminoma
AU - Ruf, Christian G
AU - Khalili-Harbi, N
AU - Sachs, S
AU - Isbarn, H
AU - Wagner, W
AU - Matthies, C
AU - Meineke, V
AU - Fisch, M
AU - Chun, F K
AU - Abend, M
N1 - Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2013/9/1
Y1 - 2013/9/1
N2 - PURPOSE: We screened 90 potential parameters as biomarkers of metastatic seminoma to facilitate detection and eliminate unnecessary therapeutic or diagnostic efforts.MATERIALS AND METHODS: A total of 527 men with pure seminoma (diagnosed 2000 to 2011) were followed during therapy. More than 90 demographic/anamnestic (eg age, height, weight) histopathological parameters (testicular/tumor size, testicular intraepithelial neoplasia) and levels of tumor markers (eg α-fetoprotein, β-human chorionic gonadotropin, lactate dehydrogenase) in peripheral blood and testicular vein were collected for analysis via logistic regression. Previously described risk factors (tumors larger than 4 cm, infiltration of rete testis) were assessed separately.RESULTS: Established parameters such as tumor length (p = 0.0003), involvement of lymphatic (p <0.0001) or vascular channels (p = 0.0009), extent of primary tumor (p <0.0001) and infiltration of the tunica albuginea (p = 0.02) as well as new biomarkers such as absence of testicular intraepithelial neoplasia in tumor bearing testis (p = 0.03), testicular volume (p = 0.04) and tumor volume (p = 0.02) showed a significant association with metastatic disease. This association was also true of lactate dehydrogenase, human chorionic gonadotropin and α-fetoprotein (p <0.0001 at maximum). However, the discriminatory capacity of these biomarkers (concordance or ROC area) did not exceed 65% when examined alone or in combination, and higher values (up to 80%) were detected for enzyme levels. A subset of metastatic seminoma (2% to 27%) was detectable with high accuracy (positive predictive value 92% to 100%) based on enzyme measurements (p <0.0006).CONCLUSIONS: New biomarkers of metastatic seminoma were identified and previously described risk factors were validated. Further prospective studies of these novel parameters are warranted to verify our findings and to explore a potential use for detecting occult metastases.
AB - PURPOSE: We screened 90 potential parameters as biomarkers of metastatic seminoma to facilitate detection and eliminate unnecessary therapeutic or diagnostic efforts.MATERIALS AND METHODS: A total of 527 men with pure seminoma (diagnosed 2000 to 2011) were followed during therapy. More than 90 demographic/anamnestic (eg age, height, weight) histopathological parameters (testicular/tumor size, testicular intraepithelial neoplasia) and levels of tumor markers (eg α-fetoprotein, β-human chorionic gonadotropin, lactate dehydrogenase) in peripheral blood and testicular vein were collected for analysis via logistic regression. Previously described risk factors (tumors larger than 4 cm, infiltration of rete testis) were assessed separately.RESULTS: Established parameters such as tumor length (p = 0.0003), involvement of lymphatic (p <0.0001) or vascular channels (p = 0.0009), extent of primary tumor (p <0.0001) and infiltration of the tunica albuginea (p = 0.02) as well as new biomarkers such as absence of testicular intraepithelial neoplasia in tumor bearing testis (p = 0.03), testicular volume (p = 0.04) and tumor volume (p = 0.02) showed a significant association with metastatic disease. This association was also true of lactate dehydrogenase, human chorionic gonadotropin and α-fetoprotein (p <0.0001 at maximum). However, the discriminatory capacity of these biomarkers (concordance or ROC area) did not exceed 65% when examined alone or in combination, and higher values (up to 80%) were detected for enzyme levels. A subset of metastatic seminoma (2% to 27%) was detectable with high accuracy (positive predictive value 92% to 100%) based on enzyme measurements (p <0.0006).CONCLUSIONS: New biomarkers of metastatic seminoma were identified and previously described risk factors were validated. Further prospective studies of these novel parameters are warranted to verify our findings and to explore a potential use for detecting occult metastases.
KW - Adult
KW - Chorionic Gonadotropin, beta Subunit, Human
KW - Cohort Studies
KW - Combined Modality Therapy
KW - Confidence Intervals
KW - Follow-Up Studies
KW - Humans
KW - Immunohistochemistry
KW - L-Lactate Dehydrogenase
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Neoplasm Invasiveness
KW - Neoplasm Metastasis
KW - Neoplasm Staging
KW - Odds Ratio
KW - Predictive Value of Tests
KW - Retrospective Studies
KW - Risk Assessment
KW - Seminoma
KW - Testicular Neoplasms
KW - Treatment Outcome
KW - Tumor Burden
KW - Tumor Markers, Biological
KW - alpha-Fetoproteins
U2 - 10.1016/j.juro.2013.04.022
DO - 10.1016/j.juro.2013.04.022
M3 - SCORING: Journal article
C2 - 23583226
VL - 190
SP - 1046
EP - 1051
JO - J UROLOGY
JF - J UROLOGY
SN - 0022-5347
IS - 3
ER -
