Potential next generation markers of testicular germ cell tumors: miRNA-371a-3p

BackgroundTesticular germ cell tumors (TGCTs) account for approximately 98% of all testicular cancers, predominantly affecting young to middle-aged men. Early diagnosis and treatment result in a cure rate of over 95%. However, conventional serum tumor markers (STMs) such as alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-hCG), and lactate dehydrogenase (LDH), which are recommended by NCCN and EAU guidelines, have limited sensitivity, often below 60%, which diminishes their clinical utility. Recently, miRNA-371a-3p, an embryonic stem cell-associated microRNA, has been identified as being specifically expressed in TGCTs. This microRNA can be reliably detected in peripheral blood and fulfills all seven Lange-Winfield criterias for tumor markers. Notably, miRNA-371a-3p has demonstrated superior diagnostic, therapeutic, and follow-up capabilities compared to conventional STMs in TGCTs. Its potential to replace conventional STMs in clinical practice is already recognized in several clinical guidelines.MethodsA PubMed search using subject headings and free-text terms related to MicroRNA-371a-3p in TGCT management was conducted. Relevant references were also tracked, and key studies were reviewed based on predefined exclusion criteria.ResultsOut of 368 identified studies, 67 met inclusion criteria. These studies focused on MicroRNA-371a-3p's discovery, detection methods, diagnostic utility in TGCTs, and cost-effectiveness. First identified over a decade ago, microRNA-371a-3p is now established as a highly specific blood-based marker for TGCTs, valuable for diagnosis, monitoring, and follow-up, and more cost-effective than conventional STMs.ConclusionsMicroRNA-371a-3p is a promising, highly sensitive marker for TGCTs, offering better performance and cost efficiency than conventional STMs, likely to become the next-generation diagnostic tool for TGCTs.