Abstract
Testicular germ cell tumours (TGCTs) are the most frequent cancer type in young men and originate from the common precursor germ cell neoplasia in situ (GCNIS). For decades, clinical management of patients with TGCT has relied on classic serum tumour markers: α-fetoprotein, human chorionic gonadotropin subunit-β and lactate dehydrogenase. In the past 10 years, microRNAs have been shown to outperform classic serum tumour markers in the diagnosis of primary tumours and in follow-up monitoring and prediction of relapse. miR-371a-3p is the most consistent marker and exhibits >90% diagnostic sensitivity and specificity in TGCT. However, miR-371a-3p cannot be used to diagnose GCNIS or mature teratoma. Future efforts must technically standardize the microRNA-based methods internationally and introduce miR-371a-3p as a molecular liquid biopsy-based marker for TGCTs in the clinic.
Key points
-
The currently available protein-based serum markers of testicular germ cell tumours (TGCTs), α-fetoprotein (AFP), human chorionic gonadotropin subunit-β (β-HCG) and lactate dehydrogenase (LDH), show poor diagnostic performance, especially for seminomas.
-
New microRNA-based biomarkers, particularly miR-371a-3p, outperform the existing protein-based serum markers in diagnostic performance and enable detection of seminomas.
-
Validated miRNA-based tests can change clinical decision-making in the primary diagnosis and follow-up monitoring of patients with TGCT.
-
Introducing miRNA-based biomarker testing reduces the costs of patient monitoring by reducing the number of imaging scans needed in patients with negative results.
-
Novel biomarkers are needed to overcome the limitations of miR-371a-3p, such as in the diagnosis of mature teratoma and of the precursor lesion, germ cell neoplasia in situ.
-
Universal standardization of protocols is needed for detecting, quantifying and reporting miRNA-based biomarkers in patients with TGCT.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Ulbright, T. M. et al. Germ cell tumours. in WHO Classification of Tumours of the Urinary System and Male Genital Organs (eds Moch, H., Humphrey, P. A., Ulbright, T. M., Reuter, V. E.) 189–226 (IARC Press, 2016).
Skakkebaek, N. E. et al. Male reproductive disorders and fertility trends: influences of environment and genetic susceptibility. Physiol. Rev. 96, 55–97 (2016).
Rajpert-De Meyts, E., McGlynn, K. A., Okamoto, K., Jewett, M. A. S. & Bokemeyer, C. Testicular germ cell tumours. Lancet 387, 1762–1774 (2016).
Walsh, T. J., Croughan, M. S., Schembri, M., Chan, J. M. & Turek, P. J. Increased risk of testicular germ cell cancer among infertile men. Arch. Intern. Med. 169, 351–356 (2009).
Wood, H. M. & Elder, J. S. Cryptorchidism and testicular cancer: separating fact from fiction. J. Urol. 181, 452–461 (2009).
Litchfield, K. et al. Identification of 19 new risk loci and potential regulatory mechanisms influencing susceptibility to testicular germ cell tumor. Nat. Genet. 49, 1133–1140 (2017).
Wang, Z. et al. Meta-analysis of five genome-wide association studies identifies multiple new loci associated with testicular germ cell tumor. Nat. Genet. 49, 1141–1147 (2017).
Litchfield, K. et al. Large-scale sequencing of testicular germ cell tumour (TGCT) cases excludes major TGCT predisposition gene. Eur. Urol. 73, 828–831 (2018).
Sonne, S. B. et al. Analysis of gene expression profiles of microdissected cell populations indicates that testicular carcinoma in situ is an arrested gonocyte. Cancer Res. 69, 5241–5250 (2009).
Lobo, J. et al. Testicular germ cell tumors: revisiting a series in light of the new WHO classification and AJCC staging systems, focusing on challenges for pathologists. Hum. Pathol. 82, 113–124 (2018).
Dieckmann, K.-P. et al. Testicular germ-cell tumours: a descriptive analysis of clinical characteristics at first presentation. Urol. Int. 100, 409–419 (2018).
Escudero-Ávila, R. et al. Active surveillance as a successful management strategy for patients with clinical stage I germ cell testicular cancer. Clin. Transl Oncol. 21, 796–804 (2019).
Honecker, F. et al. ESMO Consensus Conference on testicular germ cell cancer: diagnosis, treatment and follow-up. Ann. Oncol. 29, 1658–1686 (2018). This article presents the consensus European guidelines on the clinical management of patients with testicular germ cell tumour, relevant for understanding the impact of miRNAs in the clinic.
Palumbo, C. et al. Contemporary incidence and mortality rates in patients with testicular germ cell tumors. Clin. Genitourin. Cancer 17, e1026–e1035 (2019).
Albers, P. et al. Guidelines on testicular cancer: 2015 update. Eur. Urol. 68, 1054–1068 (2015).
Stephenson, A. et al. Diagnosis and treatment of early stage testicular cancer: AUA guideline. J. Urol. 202, 272–281 (2019).
Aparicio, J. et al. SEOM clinical guidelines for the management of germ cell testicular cancer (2016). Clin. Transl Oncol. 18, 1187–1196 (2016).
Oosterhuis, J. W. & Looijenga, L. H. J. Human germ cell tumours from a developmental perspective. Nat. Rev. Cancer 19, 522–537 (2019). This article presents a broad perspective on the biology and classification of germ cell tumours, including from a developmental point of view, necessary to understand the relevance of the specific miRNAs discussed.
Lobo, J., Gillis, A. J. M., Jerónimo, C., Henrique, R. & Looijenga, L. H. J. Human germ cell tumors are developmental cancers: impact of epigenetics on pathobiology and clinic. Int. J. Mol. Sci. 20, 258 (2019).
Oosterhuis, J. W. & Looijenga, L. H. J. Testicular germ-cell tumours in a broader perspective. Nat. Rev. Cancer 5, 210–222 (2005).
Gillis, A. J. M. et al. Expression and interdependencies of pluripotency factors LIN28, OCT3/4, NANOG and SOX2 in human testicular germ cells and tumours of the testis. Int. J. Androl. 34, e160–e174 (2011).
Nettersheim, D. et al. The cancer/testis-antigen PRAME supports the pluripotency network and represses somatic and germ cell differentiation programs in seminomas. Br. J. Cancer 115, 454–464 (2016).
Ehrlich, Y., Beck, S. D. W., Foster, R. S., Bihrle, R. & Einhorn, L. H. Serum tumor markers in testicular cancer. Urol. Oncol. 31, 17–23 (2013).
Gilligan, T. D. et al. American Society of Clinical Oncology clinical practice guideline on uses of serum tumor markers in adult males with germ cell tumors. J. Clin. Oncol. 28, 3388–3404 (2010).
Milose, J. C., Filson, C. P., Weizer, A. Z., Hafez, K. S. & Montgomery, J. S. Role of biochemical markers in testicular cancer: diagnosis, staging, and surveillance. Open. Access. J. Urol. 4, 1–8 (2011).
Lobo, J. et al. XIST-promoter demethylation as tissue biomarker for testicular germ cell tumors and spermatogenesis quality. Cancers 11, 1385 (2019).
Kawakami, T., Okamoto, K., Ogawa, O. & Okada, Y. XIST unmethylated DNA fragments in male-derived plasma as a tumour marker for testicular cancer. Lancet 363, 40–42 (2004).
Gross, N., Kropp, J. & Khatib, H. MicroRNA signaling in embryo development. Biology 6, 34 (2017).
Nappi, L. & Nichols, C. MicroRNAs as biomarkers for germ cell tumors. Urol. Clin. North. Am. 46, 449–457 (2019).
Singla, N., Lafin, J. T. & Bagrodia, A. MicroRNAs: turning the tide in testicular cancer. Eur. Urol. 76, 541–542 (2019). This article gives a brief summary of most compelling evidence supporting the clinical utility of miRNAs in patients with testicular germ cell tumour and indicates the remaining challenges.
Murray, M. J. & Coleman, N. Can circulating microRNAs solve clinical dilemmas in testicular germ cell malignancy? Nat. Rev. Urol. 16, 505–506 (2019).
Murray, M. J. & Coleman, N. MicroRNA dysregulation in malignant germ cell tumors: more than a biomarker? J. Clin. Oncol. 37, 1432–1435 (2019).
Liu, L. et al. MicroRNA-302a sensitizes testicular embryonal carcinoma cells to cisplatin-induced cell death. J. Cell. Physiol. 228, 2294–2304 (2013).
Dieckmann, K.-P., Frey, U. & Lock, G. Contemporary diagnostic work-up of testicular germ cell tumours. Nat. Rev. Urol. 10, 703–712 (2013).
Barrisford, G. W. et al. Role of imaging in testicular cancer: current and future practice. Future Oncol. 11, 2575–2586 (2015).
Dieckmann, K.-P., Kulejewski, M., Pichlmeier, U. & Loy, V. Diagnosis of contralateral testicular intraepithelial neoplasia (TIN) in patients with testicular germ cell cancer: systematic two-site biopsies are more sensitive than a single random biopsy. Eur. Urol. 51, 175–183 (2007).
Rajpert-De Meyts, E., Nielsen, J. E., Skakkebaek, N. E. & Almstrup, K. Diagnostic markers for germ cell neoplasms: from placental-like alkaline phosphatase to micro-RNAs. Folia Histochem. Cytobiol. 53, 177–188 (2015).
Kier, M. G. G. et al. Screening for carcinoma in situ in the contralateral testicle in patients with testicular cancer: a population-based study. Ann. Oncol. 26, 737–742 (2015).
Holzbeierlein, J. M., Sogani, P. C. & Sheinfeld, J. Histology and clinical outcomes in patients with bilateral testicular germ cell tumors: the Memorial Sloan Kettering Cancer Center experience 1950 to 2001. J. Urol. 169, 2122–2125 (2003).
Dieckmann, K.-P. et al. Serum levels of microRNA-371a-3p (M371 test) as a new biomarker of testicular germ cell tumors: results of a prospective multicentric study. J. Clin. Oncol. 37, 1412–1423 (2019). This article presents data of a large prospective multicentre study of the clinical utility of miR-371a-3p in the diagnosis and follow-up monitoring of patients with testicular germ cell tumour, compared with classic serum tumour markers.
Dieckmann, K.-P., Anheuser, P., Simonsen, H. & Höflmayer, D. Pure testicular seminoma with non-pathologic elevation of alpha fetoprotein: a case series. Urol. Int. 99, 353–357 (2017).
Murray, M. J., Huddart, R. A. & Coleman, N. The present and future of serum diagnostic tests for testicular germ cell tumours. Nat. Rev. Urol. 13, 715–725 (2016). This article discusses the several limitations of classic serum tumour markers in the management of patients with testicular germ cell tumour compared with miRNAs.
Ahmad, A. Non-coding RNAs: a tale of junk turning into treasure. Noncoding RNA Res. 1, 1–2 (2016).
Richard Boland, C. Non-coding RNA: it’s not junk. Dig. Dis. Sci. 62, 1107–1109 (2017).
Xi, X. et al. RNA biomarkers: frontier of precision medicine for cancer. Noncoding RNA 3, E9 (2017).
Bing, Z. et al. MicroRNA expression profiles of seminoma from paraffin-embedded formalin-fixed tissue. Virchows Arch. 461, 663–668 (2012).
Gillis, A. J. M. et al. High-throughput microRNAome analysis in human germ cell tumours. J. Pathol. 213, 319–328 (2007).
Novotny, G. W. et al. MicroRNA expression profiling of carcinoma in situ cells of the testis. Endocr. Relat. Cancer 19, 365–379 (2012).
Vilela-Salgueiro, B. et al. Germ cell tumour subtypes display differential expression of microRNA371a-3p. Philos. Trans. R. Soc. Lond. B Biol. Sci. 373, 20170338 (2018).
Voorhoeve, P. M. et al. A genetic screen implicates miRNA-372 and miRNA-373 as oncogenes in testicular germ cell tumors. Cell 124, 1169–1181 (2006). The first work identifying miRNAs of the miR-371-373 cluster as informative in testicular germ cell tumours.
Dieckmann, K.-P. et al. MicroRNAs miR-371-3 in serum as diagnostic tools in the management of testicular germ cell tumours. Br. J. Cancer 107, 1754–1760 (2012).
Gillis, A. J. M. et al. Targeted serum miRNA (TSmiR) test for diagnosis and follow-up of (testicular) germ cell cancer patients: a proof of principle. Mol. Oncol. 7, 1083–1092 (2013).
Rijlaarsdam, M. A. et al. Identification of known and novel germ cell cancer-specific (embryonic) miRs in serum by high-throughput profiling. Andrology 3, 85–91 (2015).
Murray, M. J. et al. A pipeline to quantify serum and cerebrospinal fluid microRNAs for diagnosis and detection of relapse in paediatric malignant germ-cell tumours. Br. J. Cancer 114, 151–162 (2016).
Belge, G., Dieckmann, K.-P., Spiekermann, M., Balks, T. & Bullerdiek, J. Serum levels of microRNAs miR-371-3: a novel class of serum biomarkers for testicular germ cell tumors? Eur. Urol. 61, 1068–1069 (2012).
Murray, M. J. et al. Identification of microRNAs from the miR-371 373 and miR-302 clusters as potential serum biomarkers of malignant germ cell tumors. Am. J. Clin. Pathol. 135, 119–125 (2011).
Syring, I. et al. Circulating serum miRNA (miR-367-3p, miR-371a-3p, miR-372-3p and miR-373-3p) as biomarkers in patients with testicular germ cell cancer. J. Urol. 193, 331–337 (2015).
Spiekermann, M. et al. MicroRNA miR-371a-3p in serum of patients with germ cell tumours: evaluations for establishing a serum biomarker. Andrology 3, 78–84 (2015).
Dieckmann, K.-P. et al. MicroRNA miR-371a-3p – a novel serum biomarker of testicular germ cell tumors: evidence for specificity from measurements in testicular vein blood and in neoplastic hydrocele fluid. Urol. Int. 97, 76–83 (2016).
Salvatori, D. C. F. et al. The microRNA-371 family as plasma biomarkers for monitoring undifferentiated and potentially malignant human pluripotent stem cells in teratoma assays. Stem Cell Rep. 11, 1493–1505 (2018).
Almstrup, K. et al. Screening of subfertile men for testicular carcinoma in situ by an automated image analysis-based cytological test of the ejaculate. Int. J. Androl. 34, e21–e30 (2011).
van Casteren, N. J. et al. Noninvasive detection of testicular carcinoma in situ in semen using OCT3/4. Eur. Urol. 54, 153–158 (2008).
van Agthoven, T. & Looijenga, L. H. J. Accurate primary germ cell cancer diagnosis using serum based microRNA detection (ampTSmiR test). Oncotarget 8, 58037–58049 (2017).
Radtke, A. et al. Can germ cell neoplasia in situ be diagnosed by measuring serum levels of microRNA371a-3p? J. Cancer Res. Clin. Oncol. 143, 2383–2392 (2017).
Pelloni, M. et al. Differential expression of miRNAs in the seminal plasma and serum of testicular cancer patients. Endocrine 57, 518–527 (2017).
Boellaard, W. P. A. et al. Cellular origin of microRNA-371a-3p in healthy males based on systematic urogenital tract tissue evaluation. Andrology 7, 463–468 (2019).
Radtke, A. et al. Expression of miRNA-371a-3p in seminal plasma and ejaculate is associated with sperm concentration. Andrology 7, 469–474 (2019).
Kollmannsberger, C. et al. Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance. J. Clin. Oncol. 33, 51–57 (2015).
Beard, C. J. et al. Follow-up management of patients with testicular cancer: a multidisciplinary consensus-based approach. J. Natl Compr. Canc. Netw. 13, 811–822 (2015).
Beyer, J. et al. Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. Ann. Oncol. 24, 878–888 (2013).
Schaapveld, M. et al. Risk and prognostic significance of metachronous contralateral testicular germ cell tumours. Br. J. Cancer 107, 1637–1643 (2012).
Hamilton, R. J. et al. Treatment of relapse of clinical stage I nonseminomatous germ cell tumors on surveillance. J. Clin. Oncol. 37, 1919–1926 (2019).
Trigo, J. M. et al. Tumor markers at the time of recurrence in patients with germ cell tumors. Cancer 88, 162–168 (2000).
Nicholson, B. D. et al. The diagnostic performance of current tumour markers in surveillance for recurrent testicular cancer: a diagnostic test accuracy systematic review. Cancer Epidemiol. 59, 15–21 (2019).
Anheuser, P. et al. Serum levels of microRNA371a-3p: a highly sensitive tool for diagnosing and staging testicular germ cell tumours: a clinical case series. Urol. Int. 99, 98–103 (2017).
van Agthoven, T., Eijkenboom, W. M. H. & Looijenga, L. H. J. microRNA-371a-3p as informative biomarker for the follow-up of testicular germ cell cancer patients. Cell. Oncol. 40, 379–388 (2017).
Dieckmann, K.-P. et al. Serum levels of microRNA miR-371a-3p: a sensitive and specific new biomarker for germ cell tumours. Eur. Urol. 71, 213–220 (2017).
Terbuch, A. et al. MiR-371a-3p serum levels are increased in recurrence of testicular germ cell tumor patients. Int. J. Mol. Sci. 19, E3130 (2018).
Rosas Plaza, X. et al. miR-371a-3p, miR-373-3p and miR-367-3p as serum biomarkers in metastatic testicular germ cell cancers before, during and after chemotherapy. Cells 8, E1221 (2019).
Nappi, L. et al. Developing a highly specific biomarker for germ cell malignancies: plasma miR371 expression across the germ cell malignancy spectrum. J. Clin. Oncol. 37, 3090–3098 (2019). This is a large study demonstrating 100% specificity in diagnosing active germ cell malignancy using miR-371a-3p.
Leão, R. et al. Serum miRNA predicts viable disease after chemotherapy in patients with testicular nonseminoma germ cell tumor. J. Urol. 200, 126–135 (2018). This article describes evidence on the utility of miRNAs in detecting viable germ cell malignancy after chemotherapy.
Logothetis, C. J., Samuels, M. L., Trindade, A. & Johnson, D. E. The growing teratoma syndrome. Cancer 50, 1629–1635 (1982).
Hiester, A., Nettersheim, D., Nini, A., Lusch, A. & Albers, P. Management, treatment, and molecular background of the growing teratoma syndrome. Urol. Clin. North. Am. 46, 419–427 (2019).
Paffenholz, P., Pfister, D., Matveev, V. & Heidenreich, A. Diagnosis and management of the growing teratoma syndrome: a single-center experience and review of the literature. Urol. Oncol. 36, 529.e23–529.e30 (2018).
Shen, H. et al. Integrated molecular characterization of testicular germ cell tumors. Cell Rep. 23, 3392–3406 (2018). This article describes an integrated broad molecular analysis of testicular germ cell tumours, including miRNAs.
Lobo, J. et al. Identification and validation model for informative liquid biopsy-based microRNA biomarkers: insights from germ cell tumor in vitro, in vivo and patient-derived data. Cells 8, 1637 (2019).
Belge, G., Grobelny, F., Matthies, C., Radtke, A. & Dieckmann, K.-P. Serum level of microRNA-375-3p is not a reliable biomarker of teratoma. In Vivo 34, 163–168 (2020).
Lafin, J. T. et al. Serum microRNA-371a-3p levels predict viable germ cell tumor in chemotherapy-naïve patients undergoing retroperitoneal lymph node dissection. Eur. Urol. 77, 290–292 (2020).
Charytonowicz, D. et al. Cost analysis of noninvasive blood-based microRNA testing versus CT scans for follow-up in patients with testicular germ-cell tumors. Clin. Genitourin. Cancer 17, e733–e744 (2019).
Chovanec, M., Kalavska, K., Mego, M. & Cheng, L. Liquid biopsy in germ cell tumors: biology and clinical management. Expert Rev. Mol. Diagn. 20, 187–194 (2020).
Laprovitera, N., Grzes, M., Porcellini, E. & Ferracin, M. Cancer site-specific multiple microRNA quantification by droplet digital PCR. Front. Oncol. 8, 447 (2018).
Palmer, R. D. et al. Malignant germ cell tumors display common microRNA profiles resulting in global changes in expression of messenger RNA targets. Cancer Res. 70, 2911–2923 (2010).
Murray, M. J. & Coleman, N. Testicular cancer: a new generation of biomarkers for malignant germ cell tumours. Nat. Rev. Urol. 9, 298–300 (2012).
Mego, M. et al. Clinical utility of plasma miR-371a-3p in germ cell tumors. J. Cell. Mol. Med. 23, 1128–1136 (2019).
Radtke, A. et al. The novel biomarker of germ cell tumours, micro-RNA-371a-3p, has a very rapid decay in patients with clinical stage 1. Urol. Int. 100, 470–475 (2018).
Bossuyt, P. M. et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ 351, h5527 (2015).
Nørgaard-Pedersen, B. et al. Tumour markers in testicular germ cell tumours five-year experience from the DATECA study 1976–1980. Acta Radiol. Oncol. 23, 287–294 (1984).
Kausitz, J., Ondrus, D., Belan, V. & Matoska, J. Monitoring of patients with non-seminomatous germ cell tumors of the testis by determination of alpha-fetoprotein and beta-human chorionic gonadotropin levels and by computed tomography. Neoplasma 39, 357–361 (1992).
Javadpour, N. Limitation of AFP and HCG in testicular cancer. Urology 17, 218 (1981).
Venkitaraman, R. et al. The utility of lactate dehydrogenase in the follow-up of testicular germ cell tumours. BJU Int. 100, 30–32 (2007).
Gels, M. E. et al. Importance of a new tumor marker TRA-1-60 in the follow-up of patients with clinical stage I nonseminomatous testicular germ cell tumors. Ann. Surg. Oncol. 4, 321–327 (1997).
Acknowledgements
The authors receive funding from Innovation Fund Denmark and the Børnecancerfonden (grant numbers 14-2013-4 and 2016-0304 to K.A., N.M. and E.R.-De M.); ReproUnion and the Svend Andersen Foundation (no grant numbers, to K.A. and N.M.); FCT (Fundação para a Ciência e Tecnologia; grant numbers POCI-01-0145-FEDER-29043 and SFRH/BD/132751/2017 to J.L.); and Deutsche Krebshilfe (grant number 70113186 to G.B. and K.-P.D.).
Review criteria
We performed a review of PubMed (2019), using the search terms of “germ cell cancer” or “germ cell tumour”, “miRNA” and “plasma” and focused on papers relating to diagnostics (Table 1). Studies were reviewed according to the Standards for Reporting Diagnostic Accuracy Studies (STARD) guidelines: https://www.equator-network.org/reporting-guidelines/stard/.
Author information
Authors and Affiliations
Contributions
K.A., J.L., N.M., E.R.-De M., L.H.J.L. and K.-P.D. researched data for and wrote the manuscript. All authors made substantial contributions to discussion of the content and reviewed and edited the manuscript before submission.
Corresponding authors
Ethics declarations
Competing interests
K.-P.D. and G.B. each possess 9.7% ownership shares in miRdetect GmbH, Bremen. All remaining authors declare no competing interests.
Additional information
Peer review information
Nature Reviews Urology thanks D. Nettersheim, R. Huddart and P. Giannatempo for their contribution to the peer review of this work.
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Glossary
- Germ cell neoplasia in situ
-
(GCNIS). The pre-invasive lesion from which type II testicular germ cell tumours (seminomas and non-seminomas) derive.
- Cryptorchidism
-
A condition in which the testes have not descended into the scrotum.
- Disorders of sex development
-
Conditions in which the gonads and genitalia have not developed as expected, sometimes resulting in gender ambiguity or even a gender opposite to that determined by genetics.
- Testicular dysgenesis syndrome
-
A syndrome that is caused by poor gonadal development in fetal life and later manifests as either poor semen quality, cryptorchidism, some forms of hypospadias or testicular germ cell cancer.
- Sex-determination
-
The process of gonadal development into either testes or ovaries.
- Seminomas
-
Morphologically homogeneous subtype of testicular germ cell tumours derived from germ cell neoplasia in situ.
- Non-seminomas
-
Heterogeneous subtype of testicular germ cell tumours that can be composed of embryonal carcinoma, teratoma, yolk sac tumour and choriocarcinoma.
- Orchiectomy
-
Surgical removal of a testis.
- Liquid biopsies
-
Analyses of body fluids, most commonly a blood sample, for biomarkers that can diagnose a disease or condition.
- miRNAs
-
Small molecules of RNA that are 21–24 bases long.
- Classic serum tumour markers
-
Protein-based biomarkers in serum commonly used for managing patients with testicular germ cell tumours. They include α-fetoprotein (AFP), human chorionic gonadotropin subunit-β (β-HCG), and lactate dehydrogenase (LDH).
Rights and permissions
About this article
Cite this article
Almstrup, K., Lobo, J., Mørup, N. et al. Application of miRNAs in the diagnosis and monitoring of testicular germ cell tumours. Nat Rev Urol 17, 201–213 (2020). https://doi.org/10.1038/s41585-020-0296-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41585-020-0296-x
This article is cited by
-
Testicular neoplasms: the interrelationships of serum levels of microRNA-371a-3p (M371) and classical tumor markers with histology, clinical staging, and age—a statistical analysis
Journal of Cancer Research and Clinical Oncology (2023)
-
Advancing clinical and translational research in germ cell tumours (GCT): recommendations from the Malignant Germ Cell International Consortium
British Journal of Cancer (2022)
-
Detection of recurrences using serum miR-371a-3p during active surveillance in men with stage I testicular germ cell tumours
British Journal of Cancer (2022)
-
Biomarkers of disease recurrence in stage I testicular germ cell tumours
Nature Reviews Urology (2022)
-
Associations of serum levels of microRNA-371a-3p (M371) with risk factors for progression in nonseminomatous testicular germ cell tumours clinical stage 1
World Journal of Urology (2022)