Testicular Cancer: A New Generation of Biomarkers for Malignant Germ Cell Cancer

Dear Colleagues,

Testicular germ cell tumors (TGCTs) are the most common neoplasia in young men. Although therapeutic approaches have improved, approximately 25% of the patients relapse or drug-resistant disease. For decades, clinical management has relied on classic serum tumors markers: α-fetoprotein, HCG-subunit-β and LDH. However, these markers are only elevated in ~60% of patients at the time of primary diagnosis. As a result, novel universal biomarkers for testicular malignant GCTs are required.

Clinically, most informative immunohistochemical markers for TGCTs are genes expressed in primordial germ cells/gonocytes such as placental-like alkaline phosphatase, OCT4, NANOG, AP-2γ, HMGA1, GPR30 and LIN28. Some of these markers can also be used for immunocytochemistry to detect GCNIS in semen samples.

Given their regulatory role in gene expression during embryonic development, a number of embryonic miRNAs have been explored as disease biomarkers in patients with TGCT. In the future, circulating microRNAs might be useful in diagnosis and prognostication of TGCTs. 

Finally, proteomic approach can identify biological differences in TGCT and can detect new markers with the potential to distinguish between different histologic subtypes of these tumors. 

In summary, research advances have provided clinicians with a panel of molecular markers, which allow specific diagnosis and are very useful for early detection at the precursor stage and for monitoring of patients during the follow-up.

Dr. Domenico Milardi
Guest Editor

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• Testicular Cancer
• Testicular Germ Cell Cancer
• Biomarkers
• Immunohistochemical markers
• microRNAs
• Cancer therapy
• Follow-up
• Epigenetic