A subfertile patient diagnosed with testicular carcinoma in situ by immunocytological staining for AP-2gamma in semen samples: case report

Hum Reprod. 2005 Mar;20(3):579-82. doi: 10.1093/humrep/deh759. Epub 2005 Jan 13.

Abstract

The incidence of testicular cancer is rising. Despite a high cure rate, efforts should be made to obtain diagnosis at the pre-invasive intratubular carcinoma in situ (CIS) stage, as the disease is potentially lethal and treatment has severe side-effects, especially regarding reproductive function. CIS diagnosis is presently only possible by a surgical biopsy of the testis. Immunocytological staining for transcription factor activator protein (AP-2gamma), previously identified as a marker for neoplastic germ cells, was performed in centrifuged samples of ejaculates obtained from 104 andrological patients, including patients with testicular cancer and subfertility. Cells positive for AP-2gamma were found only in semen samples from patients diagnosed a priori with testicular neoplasms and, surprisingly, in a 23 year old control subject with oligozoospermia and no symptoms of a germ cell tumour. Testicular biopsies performed during the follow-up of this patient revealed widespread CIS in one testicle, thus proving a potential diagnostic value of the new marker. For the first time, a patient without clinical symptoms of testicular neoplasia was diagnosed at the pre-invasive CIS stage using a new, simple method based on immunocytological staining of a semen sample for AP-2gamma, a novel marker for CIS. The value of this method for diagnostic use in the clinic requires further careful validation in a large series of patients and controls, but the preliminary results are promising.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers, Tumor / analysis
  • Carcinoma in Situ / complications*
  • Carcinoma in Situ / diagnosis*
  • Carcinoma in Situ / pathology
  • DNA-Binding Proteins / analysis*
  • Humans
  • Immunohistochemistry / methods
  • Infertility, Male / complications*
  • Male
  • Neoplasm Staging
  • Oligospermia / complications
  • Semen / chemistry*
  • Staining and Labeling
  • Testicular Neoplasms / complications*
  • Testicular Neoplasms / diagnosis*
  • Testicular Neoplasms / pathology
  • Transcription Factor AP-2
  • Transcription Factors / analysis*

Substances

  • Biomarkers, Tumor
  • DNA-Binding Proteins
  • TFAP2C protein, human
  • Transcription Factor AP-2
  • Transcription Factors