Gamma Glutamyl Transpeptidase Effect in Testicular Tumor; Is a New Biomarker Born?

Öz

Objective: The aim of this study is to investigate the use of serum gamma-glutamyl transpeptidase level as a biomarker especially in seminomatous subtype disease in testicular tumor patients and to investigate the superiority of biomarkers currently in use, and to examine the role of serum gamma-glutamyl transpeptidase levels in chemotherapy response, maintenance and nephrotoxicity in patients receiving cisplatin-based chemotherapy.

Material and Methods: This study was carried out by retrospectively scanning the data of patients diagnosed with testicular tumor and underwent radical inguinal orchiectomy. Age, tumor histology, subtype and stage, tumor side and size, presence of microlithiasis and testicular intraepithelial neoplasia, tumor size and rete testis invasion in patients with seminoma, presence of lymphovascular invasion and percentage of embryonal cancer in non-seminomatous patients, preoperative and postoperative gamma-glutamyl transpeptidase, alpha feto protein, lactate dehydrogenase and beta human chorionic gonadotropin levels, postoperative treatment (chemotherapy and retroperitoneal lymph node dissection), cisplatin therapy status, and post-therapy serum creatinine levels and chemotherapy response were examined in the study.

Results: Our study was carried out with a total of 96 patients after exclusion criteria were applied. It was observed that the preoperative and postoperative levels of serum gamma-glutamyl transpeptidase value were not correlated with alpha feto protein, lactate dehydrogenase and beta human chorionic gonadotropin in both seminoma and nonseminomatous testicular cancers. Age, tumor histology, seminoma subtype, rete testis invasion in seminoma and tumor size in seminoma were found to be significantly correlated as factors that could predict the level of gamma-glutamyl transpeptidase.

Conclusion: The serum gamma-glutamyl transpeptidase enzyme appears to be a new biomarker independent of current biomarkers in seminoma patients. It has been concluded that it is a biomarker that supports rete testis invasion and tumor being larger than 4 cm which are known as bad risk factors in patients with classical subtype seminoma with advanced age.

Anahtar Kelimeler

• Biomarker
• Gamma-glutamyl transpeptidase
• Testicular tumor

TESTİS TÜMÖRÜNDE GAMA GLUTAMİL TRANSPEPTİDAZ ETKİSİ; YENİ BİR BİYOBELİRTEÇ Mİ DOĞUYOR?

Öz

Amaç: Bu çalışmanın amacı testis tümörü hastalarında serum gama-glutamil transpeptidaz düzeyinin özellikle seminomatöz alt tipteki hastalıkta bir biyobelirteç olarak kullanılabilirliğinin, mevcut kullanımda olan biyobelirteçlere üstünlüğünün araştırılması ile sisplatin temelli kemoterapi alan hastalarda serum gama-glutamil transpeptidaz seviyelerinin kemoterapi yanıtı, devamı ve nefrotoksisitedeki rollerini incelemektir.

Gereç ve Yöntemler: Bu çalışma testis tümörü tanısı alıp radikal inguinal orşiektomi uygulanan hastaların verilerinin retrospektif olarak taranması şeklinde gerçekleştirildi. Yaş, tümör histolojisi, alt tipi ve evresi, tümör tarafı ve boyutu, mikrolithiazis ve testiküler intraepitelyal neoplazi varlığı, seminomlu hastalarda tümör boyutu ve rete testis invazyonu, non-seminomatöz hastalarda lenfovasküler invazyon varlığı ve embriyonel kanser yüzdesi, preoperatif ve postoperatif gama-glutamil transpeptidaz, alfa feto protein, laktat dehidrojenaz ve beta human chorionic gonadotropinin seviyeleri, postoperatif verilen tedavi (kemoterapi ve retroperitoneal lenf nodu diseksiyonu), sisplatin alma durumu ile sonrasında serum kreatinin seviyeleri ve kemoterapi cevabı gibi değişkenler çalışmada incelendi.

Bulgular: Çalışmamız, hariç tutma kriterleri sonrası toplam 96 hasta ile gerçekleştirildi. Serum gama-glutamil transpeptidaz değerinin preoperatif ve postoperatif seviyelerinin alfa feto protein, laktat dehidrojenaz ve beta human chorionic gonadotropinin ile hem seminom, hem de nonseminomatöz testis kanserlerinde korelasyonunun olmadığı izlenmiştir. Gama-glutamil transpeptidaz seviyesini predikte edebilecek faktörler olarak yaş, tümör histolojisi, seminom alt tipi, seminomda rete testis invazyonu ve seminomdaki tümör boyutunun anlamlı derecede ilişkili olduğu bulunmuştur.

Sonuç: Serum gama-glutamil transpeptidaz enzimi seminom hastalarında şu anki biyobelirteçlerden bağımsız olarak yeni bir biyobelirteç gibi görünmektedir. Daha ileri yaşı olan, klasik alt tipli seminom hastalarında kötü risk faktörleri olarak bilinen rete testis invazyonunu ve tümörün 4 cm’den büyük oluşunu destekleyen bir biyobelirteç olduğu sonucuna ulaşılmıştır.

Anahtar Kelimeler

• Biyobelirteç
• Gama-glutamil transpeptidaz
• Testis tümörü.

Kaynakça

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