title: A subfertile patient diagnosed with testicular carcinoma in situ by immunocytological staining for AP-2gamma in semen samples: case report.
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.
authors.affiliation: University Department of Growth and Reproduction (GR-5064), Rigshospitalet Blegdamsvej 9, DK-2100 Copenhagen, Denmark. chh@dadlnet.dk
authors.forename: C E
authors.initials: CE
authors.lastname: Hoei-Hansen
authors.forename: E
authors.initials: E
authors.lastname: Rajpert-De Meyts
authors.forename: E
authors.initials: E
authors.lastname: Carlsen
authors.forename: K
authors.initials: K
authors.lastname: Almstrup
authors.forename: H
authors.initials: H
authors.lastname: Leffers
authors.forename: N E
authors.initials: NE
authors.lastname: Skakkebaek
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D002278:Carcinoma in Situ / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D004268:DNA-Binding Proteins / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007248:Infertility, Male / Q000150:complications*; D008297:Male; D009367:Neoplasm Staging; D009845:Oligospermia / Q000150:complications; D012661:Semen / Q000737:chemistry*; D013194:Staining and Labeling; D013736:Testicular Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D050656:Transcription Factor AP-2; D014157:Transcription Factors / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; C493679:TFAP2C protein, human; D050656:Transcription Factor AP-2; D014157:Transcription Factors