Moccia, Augusta (2024) Inflammatory mediators as biomarkers for testicular cancer diagnosis and follow-up. [Tesi di dottorato]

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Abstract

Germ cell testicular cancer (GTC) represents 95% of testicular tumors and can be divided in three main categories, which include prepuberal, adolescent-young adult and spermatocytic seminoma (of the elder males). It derives from germ cells at different developmental stages and represents 1% of all the male tumors but it is the most common type of cancer in males between 15 and 34. The incidence is raising all over the world, while more efficient treatments have brought a reduction in mortality. Two types of GTC can be identified: i) Seminomas and ii) Non-seminomas. The classical clinical presentation is a painless lump in the testicle. After identifying testicular mass with ul-trasound, it is necessary to perform radical orchiectomy to have definitive diagnosis. Chest-abdomen-pelvis TC and determination of tumoral serum markers are needed to stage the disease. The markers usually used are beta-HCG, alpha-fetoprotein (AFP) and LDH. Due to low sensitivity and specificity of the currently used markers, it is mandatory to discover novel mol-ecules to be used for both diagnosis and follow-up. Therefore, we have considered molecules involved in inflammation, as cytokines and growth factors. Indeed, cancer is a disease largely accompanied by disfunction of the cytokines network and GTCs are largely infiltrated by immune cells. Moreover, the testicular tumor microenvironment is significantly influenced by high levels of proinflammatory and anti-inflammatory cytokines. The clinical course of a cancer is affected by the interaction of tumor cells with patient’s immune system. It is conceivable that immunological parameters may be used as markers of prognostic, diagnostic or predictive value. To sum up, elevated levels of several cytokines and growth factors have been found in patients with cancer, either in the serum or in the tumoral microenvironment and may be of substantial help for GTC characterization.

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