Neue Tumormarker bei Hodentumoren – im hier und jetzt und in der Zukunft

Zusammenfassung

Keimzelltumore sind die häufigsten Tumorentitäten bei jungen Männern. Seit der Einführung der platinbasierten Chemotherapie in den 1970er-Jahren können die meisten Patienten trotz der Aggressivität der Keimzelltumoren kurativ behandelt werden. Für Diagnostik, Therapiemonitoring und Nachsorge werden möglichst optimale Serumtumormarker benötigt, an die hohe Anforderungen gestellt werden. Die konventionellen Hodentumormarker humanes Choriongonadotropin (hCG), Alpha-Fetoprotein (AFP) und Laktatdehydrogenase (LDH) werden diesen Anforderungen nur mit einer unzureichenden Sensitivität gerecht (30–70%). Die in den letzten Jahrzehnten untersuchten Marker wie PLAP, CEA und NSE haben sich nicht durchgesetzt. Aktuell wird besonders die miRNA-371 erforscht. Gesicherte Erkenntnisse liegen vor für das initiale Staging mit deutlich besseren Spezifitäten der miRNA-371 im Vergleich zu den konventionellen Tumormarkern. Für weitere mögliche klinische Einsatzgebiete wie der Nachsorge, dem Therapiemonitoring oder bei Residualtumoren erfolgen weitere prospektive Studien, um auch hier das revolutionäre Potenzial der miRNA-371 zu untersuchen. Weiterhin wird aktuell an zirkulierenden Tumorzellen (CTCs) und zellfreier DNA (cfNA) in verschiedenen Anwendungsgebieten geforscht. In Bezug auf Keimzelltumore des Hodens stehen diese Analysen jedoch noch am Anfang, aber man erhofft sich hiervon eine weitere suffiziente Möglichkeit Serumtumormarker einzusetzen.

Abstract

Germ cell tumors of the testis are the most common tumor entities in young men. Since the introduction of platinum-based chemotherapy in the 1970s, most patients can be cured despite the aggressiveness of germ cell tumors. Optimal serum tumor markers are required for diagnostics, therapy monitoring and aftercare, and these are subject to high requirements. The conventional testicular tumor markers human chorionic gonadotropin (hCG), alpha fetoprotein (AFP) and lactate dehydrogenase (LDH) only meet these requirements with insufficient sensitivity (30–70%). The markers investigated in recent decades, such as PLAP, CEA and NSE, have not become established. Currently, miRNA-371 is being researched in particular. Reliable findings are available for initial staging with significantly better specificities of miRNA-371 compared to conventional tumor markers. Further prospective studies are being conducted for other possible clinical applications, such as follow-up care, therapy monitoring or residual tumors, in order to investigate the revolutionary potential of miRNA-371 in these areas as well. Research is also currently being conducted on circulating tumor cells (CTCs) and cell-free DNA (cfNA) in various areas of application. With regard to germ cell tumors of the testis, however, these analyses are still in their infancy, but it is hoped that this will provide a further sufficient opportunity to use serum tumor markers.

Schlüsselwörter

Hodentumor - Keimzelltumor - Tumormarker - miR371

Keywords

Testicual Cancer - Germ Cell Tumor - Tumor marker - miR371

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