Molecular pathogenesis and molecular prognosis factors of the testicular tumor

Aim of this review article was to critically analyse the recently described zytogenetic and molecular markers for testicular germ cell tumors with reg ard to their clinical utility. The isochromosome i(12p) represents the most common and characteristic cytogenetic finding which already appears in tes ticular carcinoma in situ. A number of proto - oncogenes (Cyclin D and PTHL H) as well as putative tumor suppressor genes are localized on 12p; however , their role in pathogenesis and prognosis of testicular germ cell tumors h as not been defined yet. Clinical characteristics of patients with familial testicular germ cell tumors indicate a genetic background for the developm ent of testicular rumors. Although a number of chromosomal loci encoding po tential testicular tumor susceptibility genes have been identified, the gen etic basis of testicular cancer pathogenesis is still unknown. With regard to molecular prognostic risk factors most of the reported data on prolifera tion markers, tumor suppressor genes, proteases and adhesion molecules have to be confirmed in prospective randomized trials prior to their widespread clinical use. Based on the available data on prospective studies percentag e of embryonal carcinoma and vascular invasion appear to be the most signif icant prognosticators. Investigation and identification of those factors de termining the aggressive biologic behavior of embryonal carcinoma compared to all other histological components appear to be most promising in researc h for prognosticators of metastatic disease. In conclusion, the increasing knowledge of molecular genetic events involve d in pathogenesis and prognosis of testicular germ cell tumors will not onl y help to better understand development and progression of testicular cance r, but it also will define new approaches to classification and management of germ cell tumors.