A Differential Gene Expression Signature Identifies A Population Of Stage I Testicular Non-Seminomatous Germ Cell Tumours (Nsgct) At High Risk Of Relapse

Seventy percent of testicular non-seminomatous germ cell tumors (NSGCT) are cured with only orchiectomy, so the adjuvant treatment is an overtreatment in most patients. The objective of the study was to find a gene expression model that would help us select the patients with the highest risk of relapse. Retrospective study of 54 patients with stage I NSGCT without adjuvant treatment (48% with relapse and 52% without relapse). Gene expression differences were analyzed using the PanCancer panel. Bioinformatics tools were used to find a gene expression signature, based on the selection of embedded type characteristics, using nine classification models (Lasso, Ridge, Gradient Boosting, Random Forest, ExtraTrees, LogisticRegression, SGDC, Passive Aggressive Classifier and SVR). A nine gene model (MPL, Col24a1, NR4A1, FOSL1, CREB5, FANCB, LAMB4, ZBTB16, CALML3) was obtained with the ability to predict the risk of relapse in patients with NSGCT stage I without adjuvant treatment, AUC 0.8. Of these genes, four are related to the PI3K signaling pathway (Col24a1, NR4A1, CREB5, LAMB4). From the nine gene model highlights FOSL1, with a correlation with relapse of 0.43, and NR4A1 and ZBTB16, with a differential expression close to statistical significance (0.075 in both cases). In stage I NSGCT treated with only orchiectomy a differential gene expression signature of nine genes has been identified (MPL, Col24a1, NR4A1, FOSL1, CREB5, FANCB, LAMB4, ZBTB16, CALML3) that allows selecting those patients with a high risk of relapse, although these data need validation in a larger population of patients.