New advances in clinical biomarkers in testis cancer.

Diagnostic work-up when a testicular cancer is suspected includes a clinical examination, determination of risk factors, imaging and serum tumours markers. Tumour markers are useful in the diagnosis and staging of disease, for monitor the therapeutic response and to detect tumour recurrence. The alpha- fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-hCG) are well established as serum markers for GCTs of the testis, lactate dehydrogenase (LDH) and placental-like alkaline phosphatase (PLAP) may be alternative serological markers with less specifity. However, these markers are increased in only about 60 per cent of patients with testicular cancer. Therefore, additional tumour markers would facilitate clinical diagnosis and treatment in these patients. In this review we have evaluated the clinical application of several markers of testis cancers in serum, semen and tissue samples. Immunohistochemistry detection of some of these being solid new markers in addition to the routinely used but none have been shown to be superior to the classical markers in serum and semen samples. Further research is need in this context for the detection of new markers.