CIRCULATING GALECTIN-3, HMGB1, SURVIVIN, VEGF, GDF-15 AND PENTRAXIN-3 AS DISCRIMINATORY BIOMARKERS ACROSS HEALTHY CONTROLS, INFERTILE MEN AND PATIENTS WITH TESTICULAR CANCER: A COMPARATIVE CROSS-SECTIONAL STUDY FROM NAJAF, IRAQ

Abstract

Background: Male infertility and testicular cancer share developmental and inflammatory roots, yet no single panel of circulating proteins has been evaluated simultaneously across both conditions. We measured six serum biomarkers spanning inflammation, apoptosis inhibition and angiogenesis in three clinically distinct groups.

Methods: In this cross-sectional study of 180 men recruited in Najaf, Iraq (60 healthy fertile controls, 60 infertile men and 60 patients with testicular cancer), serum galectin-3, high mobility group box 1 (HMGB1), survivin, vascular endothelial growth factor (VEGF), growth differentiation factor-15 (GDF-15) and pentraxin-3 were quantified by enzyme-linked immunosorbent assay. Groups were compared with Welch analysis of variance and Games-Howell post-hoc testing; discrimination was assessed by receiver-operating-characteristic analysis and logistic regression.

Results: All six biomarkers rose progressively from controls, through infertile men, to patients with testicular cancer (all P < 0.001), with large effect sizes. Concentrations correlated inversely with sperm concentration, motility and morphology and directly with follicle-stimulating hormone. For separating testicular cancer from controls, areas under the curve ranged from 0.879 to 0.951, and a cross-validated six-marker panel reached 0.989; the panel reached 0.948 for infertile men versus controls and 0.863 for testicular cancer versus infertile men.

Conclusions: In this single-centre sample, the six circulating proteins were graded across the reproductive-health spectrum and discriminated the study groups with good accuracy. The findings are hypothesis-generating and require external, prospective validation before any clinical application.