Diagnostic, Prognostic and Predictive Markers in Pediatric Germ Cell Tumors-Past, Present and Future.

Michalina Jezierska,Joanna Stefanowicz,Ada Gawrychowska

doi:10.3390/diagnostics12020278

Michalina Jezierska, Joanna Stefanowicz + Show 1 more

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https://doi.org/10.3390/diagnostics12020278

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Abstract

Germ cell tumors (GCTs) are a heterogenous group of neoplasms in children and young adults, in which serum tumor markers have been demonstrated to be highly sensitive diagnostic and monitoring tools. The known "old" serum biomarkers, alpha-fetoprotein (AFP), human choriogonadotropin (β-hCG) and lactate dehydrogenase (LDH), have some limitations in sensitivity and specificity. MIRNAs from the miR-371~373 (chromosomal locus 19q13.41) and miR-302/367 (4q25) clusters are universally over-expressed in malignant GCT tissue samples. The levels of miRNAs from these clusters are elevated in the serum. They seem to be highly sensitive and specific in malignant GCTs diagnosis and disease assessment during treatment and follow-up. The aim of our review was to present the role of serum tumor markers in the clinical staging, treatment monitoring and follow-up of pediatric patients with GCTs and show new possibilities. The serum levels of miRNAs seem to be a new, promising essential tool in the clinical management of GCTs.

Highlights

Germ cell tumors (GCTs) are infrequent in childhood, occurring at a rate of 2.4 cases per million children and representing approximately 3.5% of cancers diagnosed in children and adolescents younger than 15 years
AFP values higher than in previous reports AFP values higher in term babies than in premature born AFP half-life in infants increased with postnatal age In infants after AFP-secreting tumors treatment, serial AFP assessment is advisable
Children with sacrococcygeal MGCTs treated in the German Cooperative Protocols Maligne Keimzelltumoren (MAKEI)

Summary

Introduction

Germ cell tumors (GCTs) are infrequent in childhood, occurring at a rate of 2.4 cases per million children and representing approximately 3.5% of cancers diagnosed in children and adolescents younger than 15 years. GCTs are one of the most prevalent tumors in the adolescent and young adult age group, accounting for 13.9% of all the cancers among those aged 15 to 19 years [1]. GCT precursor cells can differentiate to resemble extraembryonic structures, such as yolk sac (Yolk Sac Tumor (YST)) or placenta (choriocarcinoma (CC)). Type I tumors consist of teratomas, YSTs, or a combination of the two. Type II tumors arise and consist of seminoma, embryonal carcinomas (ECs), teratoma, YST, CC or combinations of different histologies. A precursor lesion known as germ cell neoplasia in situ (GCNIS) can be identified in type II tumors. In the 2016 World Health Organization classification of GCTs, type I and type II tumors are classified as “non-GCNIS associated” and “GCNIS associated”, respectively [2,3]

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