Clinical use of serum TRA-1-60 as tumor marker in patients with germ cell cancer.
TRA-1-60 antigen has been related to the presence of embryonal germ cell carcinoma (EC) and carcinoma in situ. Our study further investigated the clinical efficacy of TRA-1-60 as a serum tumor marker for germ cell cancer in the testis. Three groups of patients with germ cell tumors were included: Group 1, 34 patients with disseminated disease (24 nonseminomatous germ cell tumors [NSGCT] and 10 seminomatous germ cell tumors [SGCT]); this group of patients were followed during the course of chemotherapy with measurements of TRA-1-60, HCG and AFP; Group 2, 28 patients with Stage I NSGCT (22 with embryonal carcinoma [EC]-component and 6 without EC-component, median follow-up 15 months); and Group 3, 40 patients with Stage I pure SGCT (median follow-up 15 months). Seventy-eight percent of patients with disseminated EC-positive NSGCT had increased levels of TRA-1-60 before chemotherapy. After chemotherapy, levels of TRA-1-60 had dropped significantly (p < 0.01). Levels of TRA-1-60 did not normalize in 15% of NSGCT and 30% of SGCT patients after chemotherapy. This was not associated with recurrent disease. Approximately one-third of patients with Stage I NSGCT had increased values of TRA-1-60 during follow-up without having a relapse. Contrary to earlier reports TRA-1-60 is not at present useful as a tumor marker in patients with germ cell tumors. Although detecting a few early relapses the rate of false positive elevations in the tumor marker makes it unreliable in the clinical setting. Our study did confirm that elevated levels of TRA-1-60 were present in approximately 80% of patients with disseminated EC-positive NSGCT before start of chemotherapy and chemotherapy induced a significant decrease in levels of TRA-1-60. Thus, the TRA-1-60 antigen might still prove clinically useful provided that the reliability of the assay can be increased.
Lajer
Henrik
H
Department of Oncology, Rigshospitalet, Copenhagen, Denmark. H.LAJER@rh.dk
Daugaard
Gedske
G
Andersson
Anna-Maria
AM
Skakkebaek
Niels Erik
NE
D000951:Antigens, Neoplasm / Q000097:blood*; D000954:Antigens, Surface; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D018236:Carcinoma, Embryonal / Q000097:blood* / Q000188:drug therapy; D006063:Chorionic Gonadotropin / Q000032:analysis; D005500:Follow-Up Studies; D018237:Germinoma / Q000097:blood* / Q000188:drug therapy; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011509:Proteoglycans; D013736:Testicular Neoplasms / Q000097:blood* / Q000188:drug therapy; D000509:alpha-Fetoproteins / Q000032:analysis
D000951:Antigens, Neoplasm; D000954:Antigens, Surface; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D006023:Glycoproteins; D011509:Proteoglycans; C107064:TRA-1-60 antigen, human; D000509:alpha-Fetoproteins