Abstract
TRA‐1‐60 antigen has been related to the presence of embryonal germ cell carcinoma (EC) and carcinoma in situ. Our study further investigated the clinical efficacy of TRA‐1‐60 as a serum tumor marker for germ cell cancer in the testis. Three groups of patients with germ cell tumors were included: Group 1, 34 patients with disseminated disease (24 nonseminomatous germ cell tumors [NSGCT] and 10 seminomatous germ cell tumors [SGCT]); this group of patients were followed during the course of chemotherapy with measurements of TRA‐1‐60, HCG and AFP; Group 2, 28 patients with Stage I NSGCT (22 with embryonal carcinoma [EC]‐component and 6 without EC‐component, median follow‐up 15 months); and Group 3, 40 patients with Stage I pure SGCT (median follow‐up 15 months). Seventy‐eight percent of patients with disseminated EC‐positive NSGCT had increased levels of TRA‐1‐60 before chemotherapy. After chemotherapy, levels of TRA‐1‐60 had dropped significantly (p < 0.01). Levels of TRA‐1‐60 did not normalize in 15% of NSGCT and 30% of SGCT patients after chemotherapy. This was not associated with recurrent disease. Approximately one‐third of patients with Stage I NSGCT had increased values of TRA‐1‐60 during follow‐up without having a relapse. Contrary to earlier reports TRA‐1‐60 is not at present useful as a tumor marker in patients with germ cell tumors. Although detecting a few early relapses the rate of false positive elevations in the tumor marker makes it unreliable in the clinical setting. Our study did confirm that elevated levels of TRA‐1‐60 were present in ∼80% of patients with disseminated EC‐positive NSGCT before start of chemotherapy and chemotherapy induced a significant decrease in levels of TRA‐1‐60. Thus, the TRA‐1‐60 antigen might still prove clinically useful provided that the reliability of the assay can be increased. © 2002 Wiley‐Liss, Inc.