# Integrating Classical Tumor Markers and Systemic Inflammatory Indices for Enhanced Biological Profiling in Testicular Neoplasms

## TL;DR

This study combines traditional tumor markers with blood-based inflammation indicators to better understand testicular cancer biology and improve patient risk assessment.

## Contribution

The novelty lies in integrating classical tumor markers with systemic inflammatory indices to enhance biological profiling in testicular neoplasms.

## Key findings

- Non-seminoma patients had significantly higher AFP, β-HCG, and LDH levels compared to seminoma patients.
- Inflammatory indices NLR and MPV/PLT were elevated in non-seminoma cases and correlated positively with tumor markers.
- Systemic inflammation appears linked to tumor activity in testicular neoplasms.

## Abstract

Objective

This study aimed to explore the diagnostic and prognostic significance of integrating classical tumor markers, including alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (β-HCG), and lactate dehydrogenase (LDH), with inflammatory hematological indices, including neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume-to-platelet ratio (MPV/PLT), in patients with testicular neoplasms.

Materials and methods

This retrospective study included 85 patients with histologically confirmed testicular tumors (48 seminomas and 37 nonseminomas). Preoperative serum AFP, β-HCG, and LDH levels were analyzed along with the complete blood count parameters. The derived inflammatory indices (NLR and MPV/PLT) were calculated. Intergroup comparisons were performed using the Student’s t-test or Mann-Whitney U test, and correlations between tumor markers and inflammatory indices were assessed using Spearman’s analysis.

Results

The mean age did not differ significantly between the seminoma (37.5 ± 10.1 years) and non-seminoma (35.3 ± 9.2 years) groups (p > 0.05). Serum AFP and β-HCG levels were markedly elevated in non-seminoma patients (AFP: 87.24 ± 28.29 ng/mL vs. 2.58 ± 0.27 ng/mL; β-HCG: 81.45 ± 31 IU/L vs. 2.55 ± 0.76 IU/L, p < 0.01 for both). LDH levels exhibited a similar trend. Inflammatory indices (NLR and MPV/PLT) were higher in non-seminoma cases and showed positive correlations with AFP and β-HCG, suggesting a link between systemic inflammation and tumor activity.

Conclusion

Combining classical tumor markers with simple hematological indices offers an expanded perspective on the tumor biology of testicular cancer. NLR and MPV/PLT may serve as complementary markers for tumor aggressiveness and systemic inflammatory response, potentially improving risk stratification and follow-up strategies.