Laboratory parameters of 1st order – obligatory laboratory tests.
- Small blood count
- Differential blood count
- Inflammatory parameter – CRP (C-reactive protein)
- Tumor markers of testicular carcinoma (also considered prognostic factors):
- Β-HCG* (β-subunit of human chorionic gonadotropin) [Positive: 30% of cases].
- Α-fetoprotein* (AFP).
- Lactate dehydrogenase* (LDH)
- Human placental alkaline phosphatase (hPLAP).
* Tumor markers that should be determined preoperatively in patients with suspected germ cell tumor.
Further notes
- The tumor markers AFP and β-HCG as well as LDH are prognostically important and have found their way into the TNM staging system – see IGCCCG classification* of advanced testicular tumor for details. The above parameters should be determined in patients with suspected germ cell tumor (KZT) before ablation testis.
- For interpretation:
- AFP is not elevated in seminoma.Elevated AFP levels indicate non-seminomatous tumor components or non-seminoma. Any AFP elevation will result in classification of the tumor as non-seminoma.
- Elevated β-HCG indicates syncytiotrophoblastic cells in tumor tissue.
- Note: “Postoperatively, in patients with preoperatively elevated levels, serum tumor markers AFP, beta-hCG, and LDH should be monitored every 5-7 days until the normal value/the respective nadir is reached and until the serum tumor marker rises, respectively.
* International Germ Cell Cancer Collaboration Group.
Laboratory parameters 2nd order
- NSE (neuron-specific enolase) sensitivity (percentage of diseased patients in whom disease is detected by use of the test, i.e., a positive test result occurs) of approximately 60% for seminoma.
Testicular tumor screening
- General screening for early detection is not recommended; however, regular self-examination of the testes is useful, especially in young men. Instructions for self-examination are provided by the German Society of Urology in cooperation with the Professional Association of German Urologists on its Internet portal www.hodencheck.de .
