- Lafin, John;
- Scarpini, Cinzia;
- Amini, Armon;
- Konneh, Bendu;
- Howard, Jeffrey;
- Gerald, Thomas;
- Nuno, Michelle;
- Piao, Jin;
- Savelyeva, Anna;
- Wang, Zhaohui;
- Gagan, Jeffrey;
- Jia, Liwei;
- Lewis, Cheryl;
- Murray, Sarah;
- Sawa, Yun;
- Margulis, Vitaly;
- Woldu, Solomon;
- Strand, Douglas;
- Coleman, Nicholas;
- Amatruda, James;
- Frazier, A;
- Murray, Matthew;
- Bagrodia, Aditya
Circulating miR-371a-3p has excellent performance in the detection of viable (non-teratoma) germ cell tumor (GCT) pre-orchiectomy; however, its ability to detect occult disease is understudied. To refine the serum miR-371a-3p assay in the minimal residual disease setting we compared performance of raw (Cq) and normalized (∆Cq, RQ) values from prior assays, and validated interlaboratory concordance by aliquot swapping. Revised assay performance was determined in a cohort of 32 patients suspected of occult retroperitoneal disease. Assay superiority was determined by comparing resulting receiver-operator characteristic (ROC) curves using the Delong method. Pairwise t-tests were used to test for interlaboratory concordance. Performance was comparable when thresholding based on raw Cq vs. normalized values. Interlaboratory concordance of miR-371a-3p was high, but reference genes miR-30b-5p and cel-miR-39-3p were discordant. Introduction of an indeterminate range of Cq 28-35 with a repeat run for any indeterminate improved assay accuracy from 0.84 to 0.92 in a group of patients suspected of occult GCT. We recommend that serum miR-371a-3p test protocols are updated to (a) utilize threshold-based approaches using raw Cq values, (b) continue to include an endogenous (e.g., miR-30b-5p) and exogenous non-human spike-in (e.g., cel-miR-39-3p) microRNA for quality control, and (c) to re-run any sample with an indeterminate result.