{"title":"Can serum tumor marker densities according to tumor volume and testicle size be used to predict progression in patients with testicular cancer?","authors":"Aykut Demirci, Halil Başar","doi":"10.1097/CU9.0000000000000212","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The objective of this study is to determine the role of tumor marker density (TMD) values such as alpha-fetoprotein tumor volume ratio (ATVR), beta-human chorionic gonadotropin tumor volume ratio (βTVR), alpha-fetoprotein testicle size ratio (ATSR), beta-human chorionic gonadotropin testicle size ratio (βTSR), lactate dehydrogenase tumor volume ratio (LTVR), and lactate dehydrogenase testicle size ratio (LTSR) in the determination of progression-free survival (PFS) in patients with testicular cancer.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted of 95 patients followed-up in our clinic with a diagnosis of testicular cancer between January 2015 and August 2022. Patients were grouped according to clinical stage, as either early stage (<i>n</i> = 50) or advanced stage (<i>n</i> = 45). Clinical and pathological data and TMD values for all patients were recorded.</p><p><strong>Results: </strong>The median age of patients was 35 years (21-63 years). All TMDs except LTVR in advanced stage patients were found to be significantly higher than those of early stage patients (<i>p</i> < 0.05). Median ATVR (2.58 vs. 0.0), ATSR (0.63 vs. 0.03), βTVR (0.9 vs. 0.009), and βTSR (0.18 vs. 0.007) of the nonseminoma patients were found to be significantly higher than those of the seminoma patients, respectively (<i>p</i> < 0.001). Progression-free survival (months) was decreased in seminoma patients with high values of βTVR (11.3 ± 1.9 vs. 35.2 ± 0.7), βTSR (16.2 ± 3.4 vs. 35.2 ± 0.75), LTVR (17.7 ± 3.4 vs. 35.2 ± 0.7), and LTSR (21.5 ± 3.13 vs. 35.09 ± 0.8) (<i>p</i> < 0.001). Decreased PFS (months) was associated with higher values of ATVR (5.37 ± 0.7 vs. 35.05 ± 0.93), βTVR (7.4 ± 1.5 vs. 34.6 ± 1.3), ATSR (5.37 ± 0.75 vs. 35.05 ± 0.9), βTSR (7 ± 1.5 vs. 34.6 ± 1.3), and LTSR (7.9 ± 1.2 vs. 34.3 ± 1.5) in nonseminoma patients (<i>p</i> < 0.001). Based on multivariate analysis, βTVR-LTVR and ATVR-ATSR were determined to be independent risk factors for reduced PFS in seminoma and nonseminoma patients, respectively (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The results of this study suggest that the calculation of TMDs could be a promising and simple method for prediction of PFS among testicular cancer patients.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337983/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Urology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/CU9.0000000000000212","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/20 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The objective of this study is to determine the role of tumor marker density (TMD) values such as alpha-fetoprotein tumor volume ratio (ATVR), beta-human chorionic gonadotropin tumor volume ratio (βTVR), alpha-fetoprotein testicle size ratio (ATSR), beta-human chorionic gonadotropin testicle size ratio (βTSR), lactate dehydrogenase tumor volume ratio (LTVR), and lactate dehydrogenase testicle size ratio (LTSR) in the determination of progression-free survival (PFS) in patients with testicular cancer.
Materials and methods: A retrospective study was conducted of 95 patients followed-up in our clinic with a diagnosis of testicular cancer between January 2015 and August 2022. Patients were grouped according to clinical stage, as either early stage (n = 50) or advanced stage (n = 45). Clinical and pathological data and TMD values for all patients were recorded.
Results: The median age of patients was 35 years (21-63 years). All TMDs except LTVR in advanced stage patients were found to be significantly higher than those of early stage patients (p < 0.05). Median ATVR (2.58 vs. 0.0), ATSR (0.63 vs. 0.03), βTVR (0.9 vs. 0.009), and βTSR (0.18 vs. 0.007) of the nonseminoma patients were found to be significantly higher than those of the seminoma patients, respectively (p < 0.001). Progression-free survival (months) was decreased in seminoma patients with high values of βTVR (11.3 ± 1.9 vs. 35.2 ± 0.7), βTSR (16.2 ± 3.4 vs. 35.2 ± 0.75), LTVR (17.7 ± 3.4 vs. 35.2 ± 0.7), and LTSR (21.5 ± 3.13 vs. 35.09 ± 0.8) (p < 0.001). Decreased PFS (months) was associated with higher values of ATVR (5.37 ± 0.7 vs. 35.05 ± 0.93), βTVR (7.4 ± 1.5 vs. 34.6 ± 1.3), ATSR (5.37 ± 0.75 vs. 35.05 ± 0.9), βTSR (7 ± 1.5 vs. 34.6 ± 1.3), and LTSR (7.9 ± 1.2 vs. 34.3 ± 1.5) in nonseminoma patients (p < 0.001). Based on multivariate analysis, βTVR-LTVR and ATVR-ATSR were determined to be independent risk factors for reduced PFS in seminoma and nonseminoma patients, respectively (p < 0.05).
Conclusions: The results of this study suggest that the calculation of TMDs could be a promising and simple method for prediction of PFS among testicular cancer patients.
研究背景本研究旨在确定肿瘤标志物密度（TMD）值的作用，如甲胎蛋白肿瘤体积比（ATVR）、β-人绒毛膜促性腺激素肿瘤体积比（βTVR）、甲胎蛋白睾丸大小比（ATSR）、β-人绒毛膜促性腺激素睾丸大小比（βTSR）、乳酸脱氢酶肿瘤体积比（LTVR）和乳酸脱氢酶睾丸大小比（ATSR）、乳酸脱氢酶肿瘤体积比（LTVR）、甲胎蛋白睾丸大小比（ATSR）、β-人绒毛膜促性腺激素睾丸大小比（βTSR）、乳酸脱氢酶肿瘤体积比（LTVR）和乳酸脱氢酶睾丸大小比（LTSR）在确定睾丸癌患者无进展生存期（PFS）中的作用。材料与方法：我们对2015年1月至2022年8月期间在本诊所随访的95名确诊为睾丸癌的患者进行了回顾性研究。根据临床分期将患者分为早期（50 例）和晚期（45 例）。记录了所有患者的临床和病理数据以及TMD值：患者年龄中位数为 35 岁（21-63 岁）。除LTVR外，晚期患者的所有TMD值均明显高于早期患者（P < 0.05）。非精原细胞瘤患者的中位ATVR（2.58 vs. 0.0）、ATSR（0.63 vs. 0.03）、βTVR（0.9 vs. 0.009）和βTSR（0.18 vs. 0.007）分别明显高于精原细胞瘤患者（P < 0.001）。βTVR（11.3±1.9 vs. 35.2±0.7）、βTSR（16.2±3.4 vs. 35.2±0.75）、LTVR（17.7±3.4 vs. 35.2±0.7）和LTSR（21.5±3.13 vs. 35.09±0.8）值高的精原细胞瘤患者无进展生存期（月）缩短（p < 0.001）。PFS（月）的降低与较高的 ATVR（5.37 ± 0.7 vs. 35.05 ± 0.93）、βTVR（7.4 ± 1.5 vs. 34.6 ± 1.3）、ATSR（5.37 ± 0.75 vs. 35.05 ± 0.9）、βTVR（7 ± 1.5 vs. 34.6 ± 1.3）和 LTSR（7.9 ± 1.2 vs. 34.3 ± 1.5）（P < 0.001）。基于多变量分析，βTVR-LTVR和ATVR-ATSR分别被确定为精原细胞瘤和非精原细胞瘤患者PFS降低的独立风险因素（P＜0.05）：本研究结果表明，TMDs的计算是预测睾丸癌患者PFS的一种有前途的简单方法。
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