标志物阴性临床 IIA/B 期精原细胞瘤或非精原细胞瘤患者面临治疗挑战，因为 20-30% 的患者可能具有非恶性组织学特征。 MicroRNA 371a-3p (miR371) 可能是睾丸生殖细胞肿瘤 (TGCT) 中具有诊断和预测特性的生物标志物。我们评估了该生物标志物在临床 IIA/B 期 TGCT 中识别是否存在淋巴结转移 (LNM) 的预测准确性。在一组连续 24 名标志物阴性临床 IIA/B 期 TGCT 患者（n = 15 名精原细胞瘤，n = 9 非精原细胞瘤）中，在保留神经的腹膜后淋巴结切除术前 1 天评估血清 miR371。组织学显示 22/24 名患者 (91.7%) 存在转移性 TGCT，其中 22 名转移患者中有 20 名 (90.9%) 的 miR371a 结果呈阳性。组织学显示一名患者没有恶性肿瘤，另一名患者没有淋巴瘤，两人的 miR371a 检测结果均呈阴性。另外一名患有纯畸胎瘤的患者和一名患有显微镜下精原细胞瘤 LNM 的患者的 miR371a 结果呈假阴性。 miR371 检测的敏感性为 90.9%，特异性为 50%。阳性预测值为100.0%，阴性预测值为75.0%。根据现有数据，miR371a 代表了一种高度可靠的个性化肿瘤标志物，可用于预测标志物阴性 TGCT 中低容量腹膜后 LNM 的存在。 miR371 有可能被纳入淋巴结不明男性的诊断工具中，以避免不必要的治疗和相关毒性。患者摘要：我们的研究表明，生物标志物 miR371 的血液检测对于预测 IIA/B 期睾丸癌患者是否存在淋巴结转移高度可靠。对于结果模棱两可的患者，使用此测试可能有助于避免不必要的治疗。版权所有 © 2023 欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。

Patients with marker-negative clinical stage IIA/B seminoma or nonseminoma represent a therapeutic challenge, as 20-30% might harbor nonmalignant histologies. MicroRNA 371a-3p (miR371) may represent a biomarker with diagnostic and predictive properties in testicular germ cell tumors (TGCTs). We evaluated the predictive accuracy of this biomarker in identifying the presence or absence of lymph node metastases (LNMs) in clinical stage IIA/B TGCT. In a cohort of 24 consecutive patients with marker-negative clinical stage IIA/B TGCT (n = 15 seminoma, n = 9 nonseminoma) serum miR371 was assessed 1 d before nerve-sparing retroperitoneal lymphadenectomy. Histology revealed metastatic TGCT in 22/24 patients (91.7%), with positive miR371a findings for 20 of these 22 patients with metastases (90.9%). Histology revealed no malignancy in one patient and lymphoma in another, both of whom had negative miR371a findings. One additional patient with pure teratoma and one with a microscopic seminomatous LNM had false-negative miR371a findings. The miR371 assay had sensitivity of 90.9% and specificity of 50%. The positive predictive value was 100.0% and the negative predictive value was 75.0%. According to the data available, miR371a represents a highly reliable, personalized tumor marker for predicting the presence of low-volume retroperitoneal LNMs in marker-negative TGCT. miR371 has potential for inclusion in the diagnostic armamentarium for men with equivocal lymph nodes to facilitate avoidance of unnecessary treatment and the associated toxicity. PATIENT SUMMARY: Our study demonstrates that blood tests for the biomarker miR371 are highly reliable in predicting the presence of lymph node metastases in patients with stage IIA/B testicular cancer. For patients with equivocal findings, use of this test may help in avoiding unnecessary treatment.Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.