Which tumor markers are used in evaluating testicular germ cell tumors and what do they indicate?

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In evaluating testicular germ cell tumors, the key serum markers are alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH). AFP elevation is most closely linked to non-seminomatous components, especially yolk sac tumors, and pure seminomas typically do not raise AFP. Increased hCG can occur in seminomas and in non-seminomatous tumors due to trophoblastic elements, with particularly high levels suggesting choriocarcinoma or mixed histology. LDH is less specific but reflects tumor burden and helps with prognostication and monitoring response to therapy. Together, these markers inform diagnosis, help distinguish histologic components, gauge disease extent, and track treatment response or relapse. The other marker sets correspond to different cancers or non-specific organ processes and are not used to evaluate testicular germ cell tumors in the same way.