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Prediction of relapse in stage I testicular germ cell tumor patients on surveillance: investigation of biomarkers.
- Source :
-
BMC cancer [BMC Cancer] 2020 Aug 05; Vol. 20 (1), pp. 728. Date of Electronic Publication: 2020 Aug 05. - Publication Year :
- 2020
-
Abstract
- Background: Better biomarkers for assessing risk of relapse in stage I testicular germ cell tumor patients are needed, to complement classical histopathological variables. We aimed to assess the prognostic value of previously suggested biomarkers, related to proliferation (MIB-1 and TEX19) and to immune microenvironment (CXCL12, CXCR4, beta-catenin and MECA-79) in a surveillance cohort of stage I testicular germ cell tumor patients.<br />Methods: A total of 70 patients were included. Survival analyses were performed, including Cox regression models.<br />Results: Patients with vascular invasion and elevated human chorionic gonadotropin levels showed significantly poorer relapse-free survival in multivariable analysis (hazard ratio = 2.820, 95% confidence interval 1.257-6.328; hazard ratio = 3.025, 95% confidence interval 1.345-6.808). Patients with no vascular invasion but with MIB-1 staining in > 50% tumor cells showed significantly shorter relapse-free survival (p = 0.042). TEX19 nuclear immunoexpression was confirmed in spermatogonial cells, and weak cytoplasmic immunoexpression was depicted in 15/70 tumors, not significantly impacting survival. CXCL12 immunoexpression in tumor cells did not associate with relapse, but non-seminoma patients exhibiting vascular invasion and CXCL12-positive stromal/inflammatory cells showed significantly improved relapse-free survival (p = 0.015). Exclusively nuclear immunoexpression of CXCR4 associated with better relapse-free survival (p = 0.032), but not after adjusting for vascular invasion. Patients with higher beta-catenin scores showed a tendency for poorer relapse-free survival (p = 0.056). MECA-79 immunoexpression was absent.<br />Conclusions: The informative protein biomarkers (i.e., MIB-1, CXCL12, beta-catenin, and possibly CXCR4) may prove useful for risk-stratifying patients if validated in larger, multicentric and well-defined studies. Currently, classical histopathological features of testicular germ cell tumors remain key for relapse prediction.
- Subjects :
- Adult
Antibodies, Antinuclear analysis
Antibodies, Monoclonal analysis
Antigens, Surface analysis
Chemokine CXCL12 analysis
Chorionic Gonadotropin blood
Confidence Intervals
Disease-Free Survival
Humans
Male
Membrane Proteins analysis
Neoplasm Invasiveness
Neoplasm Staging
Neoplasms, Germ Cell and Embryonal mortality
Neoplasms, Germ Cell and Embryonal pathology
RNA-Binding Proteins analysis
Receptors, CXCR4 analysis
Retrospective Studies
Seminoma mortality
Seminoma pathology
Testicular Neoplasms mortality
Testicular Neoplasms pathology
Tumor Microenvironment
beta Catenin analysis
Biomarkers, Tumor analysis
Neoplasm Recurrence, Local mortality
Neoplasm Recurrence, Local pathology
Neoplasms, Germ Cell and Embryonal chemistry
Seminoma chemistry
Testicular Neoplasms chemistry
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2407
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC cancer
- Publication Type :
- Academic Journal
- Accession number :
- 32758242
- Full Text :
- https://doi.org/10.1186/s12885-020-07220-6