Dendritic cell infiltration in a patient with seminomatous germ cell tumor of the testis: is there a relationship with infertility and tumor stage?
OBJECTIVE
Inflammatory cells, such as dendritic cells, are considered to trigger the antitumoral immune response against tumors, such as testicular cancer. Male infertility associated with cancer may be due to endocrine or immunological factors. We investigated possible associations of antigen expression with dendritic cells, histiocytic cells and seminoma stage as well as with impaired spermatogenesis.


METHODS
From 1992 to 1999, 30 patients with seminoma underwent orchiectomy at our center, including 14 who underwent spermiography before orchiectomy. Streptavidin-biotin immunostaining was performed on paraffin -embedded tumor specimens using antibodies against protein S-100 for dendritic cells and CD68-KP1 antigen.


RESULTS
Light infiltration by less than 20 dendritic cells and less than 103 CD68+ cells was associated with tumor size greater than 1.5 cm. in 75% and 80% of patients, respectively. Strong infiltration by greater than 20 dendritic cells and greater than 103 CD68+ cells was associated with negative lymph nodes in 86% of patients. Slight infiltration by dendritic cells was observed in 71% of patients with a sperm count of greater than 8.6 million per ml. and in 100% with more than 45% motile sperm (p not significant and 0.02, respectively). Necrospermia increased with dendritic and CD68+ cell infiltration. No association was noted among preoperative serum tumor marker levels, the sperm count and immunostaining.


CONCLUSIONS
Sperm autoimmunity is a plausible mechanism of infertility in men with germ cell tumors. Dendritic cells may induce antitumor cell cytotoxic reactions, but may also be cytotoxic to sperm cells or lead to inhibited spermatogenesis. Further studies focusing on tumor rejection antigen and the cloning of specific cytotoxic T lymphocyte against gametes are required to confirm these finding.
Saint
Fabien
F
Department of Urology, CHRU Lille, Lille, France.
Leroy
Xavier
X
Graziana
Jean Pierre
JP
Moukassa
Donatien
D
Gosselin
Bernard
B
Biserte
Jacques
J
Chopin
Dominique
D
Rigot
Jean Marc
JM
D000328:Adult; D003713:Dendritic Cells / Q000473:pathology*; D018237:Germinoma / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007246:Infertility / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013076:Sperm Count; D013736:Testicular Neoplasms / Q000150:complications* / Q000473:pathology*