Laboratory diagnostics are usually not required!
2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification.
- Sterility diagnostics
- Spermiogram (sperm cell examination) – as part of infertility or fertility diagnostics [up to 55% of men with a grade III varicocele have a pathological (abnormal) spermiogram].
- FSH [if necessary, FSH elevation due toimpairment of Sertoli cell function]
- LH [if necessary LH increase due toimpairment of Leydig cell function]
- Testosterone [normal to subnormal]
- If testicular tumor is suspected:
- Tumor markers of testicular carcinoma: beta-HCG, α-fetoprotein – these are also considered prognostic factors.
- Lactate dehydrogenase (LDH).
- Human placental alkaline phosphatase (hPLAP).
- NSE (neuron-specific enolase) sensitivity (percentage of diseased patients in whom the disease is detected by use of the test, i.e., a positive test result occurs) of circa 60% for seminoma.
Further notes
- 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.
- The tumor markers AFP and β-HCG and LDH are prognostically important and have found their way into the TNM staging system – see IGCCCG classification* of advanced testicular tumor.
* International-Germ-Cell-Cancer-Collaboration-Group.