Towards a non-invasive method for early detection of testicular neoplasia in semen samples by identification of fetal germ cell-specific markers

47 Citations (Scopus)

Abstract

BACKGROUND: Testicular germ cell tumours (TGCTs) originate from a common precursor, carcinoma in situ (CIS). Diagnosis at the CIS stage is desirable as it minimizes the necessary treatment. A detailed clinical evaluation of an approach to detect CIS cells in the ejaculate using primordial germ cell/gonocyte markers is presented.

METHODS: Immunocytological staining for AP-2gamma [and in some cases, OCT-3/4, NANOG or placental alkaline phosphatase (PLAP)] was performed in semen samples from 294 infertile patients and 209 patients with TGCTs or other diseases.

RESULTS: Presence of AP-2gamma-stained cells was detected in 50% of participants with CIS and in 33.9% of TGCT patients before treatment (non-seminomas: 56.6%, seminomas: 17.4%). OCT-3/4 results were similar to those of AP-2gamma, whereas NANOG and PLAP stainings were unsuitable. Sensitivity was 54.5% for participants harbouring pre-invasive CIS but reduced in participants with overt TGCTs, perhaps because of obstruction. Assay specificity was 93.6%, positive predictive value (PPV) 83.3% and negative predictive value (NPV) 60.3%.

CONCLUSIONS: Immunocytological semen analysis based on expression of fetal germ cell markers in exfoliated cells has auxiliary diagnostic value, as it detects some patients with CIS/incipient tumour, but a negative result does not exclude TGCT. Further effort is needed to improve this assay, for example, by employing a more sensitive biochemical method of detection.

Original languageEnglish
JournalHuman reproduction (Oxford, England)
Volume22
Issue number1
Pages (from-to)167-73
Number of pages7
ISSN0268-1161
DOIs
Publication statusPublished - Jan 2007

Keywords

  • Adolescent
  • Adult
  • Alkaline Phosphatase
  • Carcinoma in Situ
  • DNA-Binding Proteins
  • Homeodomain Proteins
  • Humans
  • Isoenzymes
  • Male
  • Middle Aged
  • Neoplasms, Germ Cell and Embryonal
  • Octamer Transcription Factor-3
  • Predictive Value of Tests
  • Semen
  • Sensitivity and Specificity
  • Testicular Neoplasms
  • Transcription Factor AP-2
  • Tumor Markers, Biological

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