INTRODUCTION: Intratubular germ cell neoplasia (ITGCN) is a precursor to testicular germ cell cancer.
It is characterized by large germ cells with large nuclei with a hyperchromatic, coarse chromatin pattern, large prominent nucleoli and abundant pale cytoplasm. In prepubertal boys these cells are located both centrally and peripherally mixed with normal cells in the seminiferous tubules. The aim of study was to evaluate the impact of adult ITGCN-marking immunohistochemical methods in screening for ITGCN in boys with cryptorchidism.
MATERIAL AND METHODS: Histology sections from 236 testicular biopsies from 170 boys aged 1 month to 15 years operated for cryptorchidism (DSD excluded) were incubated with primary antibodies including anti-Placental-like alkaline phosphatase(PLAP), antiOct3/4, anti-C-kit and anti-D2-40 receptor.
RESULTS: One boy 1.1 year old had ITGCN and all positive markers. The prevalence of PLAP-positive and C-kit- positive staining of germ cells in testicular biopsies was in age group < 1 year=98% and 71%, 1-< 2 years=82% and 49%, 2-< 3 years=74% and 16% and 3-< 15 years=60% and 34%. PLAP negative germ cells did not express any of the other described antigens. In none of the 116 testes from boys older than 1 year and 7 months any Oct3/4 or D2-40 positive germ cells were identified. Until that age 33% and 8% respectively were Oct3/4 or D2-40 positive.
CONCLUSION: Adult ITGCN/cancer immunohistochemical markers cannot stand alone for ITGCN screening in infant boys with cryptorchidism, because positive immunohistochemistry is commonly seen within the age group of most orchiopexies. ITGCN is generally not plausible to originate during fetal development in cryptorchidism.
Written by:
Kvist K, Clasen-Linde E, Cortes D, Petersen BL, Thorup J. Are you the author?
The Department of Pediatric Surgery, Rigshospitalet, DK-2100 Copenhagen.
Reference: J Urol. 2013 Oct 3. pii: S0022-5347(13)05566-3.
doi: 10.1016/j.juro.2013.10.001
PubMed Abstract
PMID: 24095908
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