Diagnostic And Predictive Biomarkers For Testicular Cancer

By Author: vivian Creative
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The testicles, or simply testes, are part of the male reproductive system and consist of several kinds of cells. And different cells could develop into one or more types of tumors, including germ cell tumors (GCTs), stromal tumors, and secondary testicular tumors due to either congenital or acquired factors. Testicular germ cell tumors (TGCTs), which usually grow in the cells that make sperm, are the most common type of testicular tumors globally afflicting young-adult men. Even though this type of cancer is treatable and often curable with a more than 95% survival rate, its incidence is continuously increasing and still causing subfertility issues worldwide.

Germ cell tumors usually are featured as：

Developmental cancers that repeat several phenomena related to germ cells and embryonic development.
A model of curable cancer that show remarkable sensitivity to platinum-based chemotherapy.
Heterogeneous neoplasms that have several histological subtypes and particularities, mainly grouped into seminomas and non-seminomas.

Diagnostics for Testicular Cancer

Common testicular cancer ...
... diagnostic methods include physical exams that check the existence of lumps, swelling, or tenderness in testicles, ultrasound for further detection, imaging tests, and blood tests for tumor markers. Studies found that serum tumor markers usually will increase by 40% to 60% of all cases so they have become important tools for the detection of testicular cancers and to guide treatment and follow-up. To be specific, many testicular cancers secrete high levels of certain proteins, most of which are now classic serum tumor markers in clinic practice, including alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and testicular lactate dehydrogenase (LDH).

Challenges for Testicular Cancer Diagnosis & Treatment

Though some detection methods and treatments are available, researchers are still confronted with challenges in different aspects.

One is that current tools for diagnosing and monitoring testicular cancer patients are limited since conventional markers are elevated in only 40%-60% of cases overall. They are not effective enough to distinguish the histological composition of the lumps and several other subtypes like non-seminomas and pure seminomas. Limitations of conventional tumor biomarkers and diagnostic strategies also present when the tumor is small or when used to detect disease relapses. For instance, scrotal ultrasound can confirm the presence of a testicular mass in germ cell cancer diagnostics but is not reliable enough in discriminating malignant TGCTs from other conditions. The definitive diagnosis of malignant TGCTs is only possible after surgical resection for histopathological assessment, which stresses the need of discovering more and better non-invasive biomarkers.

Tumor biomarkers are also an important tool for treatment guidance, for which another challenge arises in the risk and stage stratification of different patients. It's reported that some young TGCT patients are enduring substantial overtreatments, such as short or long-term toxicity of platinum-based chemotherapy and radiation. The discovery of proper biomarkers will help indicate different treatment options for patients in different stages.

Moreover, poor prognosis and eventual deaths are often observed in TGCT patients developing cisplatin resistance, given no therapies have been approved to effectively treat this aggressive tumor phenotype. However, cisplatin resistance proves to be multifactorial and a result of several mechanisms and pathways, which highlights the importance of uncovering predictive biomarkers against cisplatin resistance to develop alternative targeted therapies.