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Suzuki S, Nagumo Y, Kandori S, Kojo K, Nitta S, Chihara I, Shiga M, Ikeda A, Kawahara T, Hoshi A, Negoro H, Bryan MJ, Okuyama A, Higashi T, Nishiyama H. The prognostic impact of treatment centralization in patients with testicular germ cell tumors: analysis of hospital-based cancer registry data in Japan. Int J Clin Oncol 2024; 29:318-324. [PMID: 38265529 DOI: 10.1007/s10147-023-02457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/11/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND To identify the prognostic impact of treatment centralization in patients with testicular germ cell tumors (TGCT). METHODS We used a hospital-based cancer registry data in Japan to extract seminoma and non-seminoma cases that were diagnosed in 2013, histologically confirmed, and received the first course of treatment. To compare the 5-years overall survival (OS) rates of patients stratified by institutional care volume, we performed a Cox proportional hazards regression analysis using inverse probability of treatment weighting (IPTW) method to adjust patient backgrounds. RESULTS A total of 1767 TGCT patients were identified. The 5-years OS rates for stage II and III TGCT patients treated at low-volume institutions (< 7 cases) were significantly worse than high-volume institutions (≥ 7 cases) (91.2% vs. 83.4%, p = 0.012). Histological stratification revealed that 5-year OS rates for stage II and III seminoma patients in the low-volume group were significantly worse than the high-volume group (93.5% vs. 84.5%, p = 0.041). Multivariate OS analysis using an IPTW-matched cohort showed that institutional care volume was an independent prognostic factor (hazard ratio 2.13 [95% confidence interval: 1.23-3.71], p = 0.0072). CONCLUSION Our results indicate that stage II and III TGCT patients experience lower survival rates at low-volume institutions and would benefit from treatment centralization.
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Affiliation(s)
- Shuhei Suzuki
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoshiyuki Nagumo
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shuya Kandori
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Kousuke Kojo
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Satoshi Nitta
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Ichiro Chihara
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masanobu Shiga
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Atsushi Ikeda
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takashi Kawahara
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Akio Hoshi
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiromitsu Negoro
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Mathis J Bryan
- International Medical Center, University of Tsukuba Affiliated Hospital, 2-1-1, Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Ayako Okuyama
- Center for Cancer Registries, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
- Graduate School of Nursing, St Luke's International University, 10-1 Akashicho, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Takahiro Higashi
- Center for Cancer Registries, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Argyris PP, Challa B, Satturwar S, VanKoevering KK, Wakely PE. SMARCB1-Deficient Skull Base Chondrosarcoma with 12p Duplication Presenting as Somatic-Type Malignancy Arising from Metastatic Seminoma. Head Neck Pathol 2024; 18:1. [PMID: 38236556 PMCID: PMC10796880 DOI: 10.1007/s12105-023-01610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024]
Abstract
Somatic-type malignancy (STM) can occur infrequently within a primary or metastatic testicular germ cell tumor (TGCT) and is associated with dismal prognosis and survival. STM with chondrosarcomatous features is exceedingly rare and head and neck involvement has not been previously documented. A 39-year-old white man presented with nasal obstruction and epistaxis. Imaging disclosed a 6.9-cm expansile tumor involving the nasal cavity and skull base with intraorbital and intracranial extension. The histopathologic properties of the tumor were compatible with chondrosarcoma, grade II-III. Immunohistochemically, malignant cells were strongly and diffusely positive for S100 and epithelial markers, and showed loss of SMARCB1 expression. IDH1/2 mutations were not detected. Following whole-body PET scan, a 7.0-cm left testicular mass was discovered and diagnosed as seminoma with syncytiotrophoblastic cells, stage pT3NXM1b. Extensive retroperitoneal, mediastinal, and supraclavicular lymphadenopathy was also noticed. Histopathologic examination of the left supraclavicular lymph node revealed metastatic seminoma. By FISH, most metastatic nodal seminoma cells harbored 1 to 4 copies of isochromosome 12p, while the chondrosarcoma featured duplication of 12p. Presence of a malignant TGCT with disseminated supradiaphragmatic lymphadenopathy, the unique immunophenotypic properties of the skull-based chondrosarcoma and lack of IDH1/2 aberrations with gain of 12p strongly support the diagnosis of STM chondrosarcoma arising from metastatic TGCT. The patient did not respond to chemotherapy and succumbed three months after diagnosis. Although exceedingly uncommon, metastasis to the head and neck may occur in patients with TGCT. This case of STM chondrosarcoma demonstrated divergent immunophenotypic and molecular characteristics compared to "typical" examples of head and neck chondrosarcoma. High index of suspicion is advised regarding the diagnosis of lesions that present with otherwise typical histomorphology but unexpected immunohistochemical or molecular features.
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Affiliation(s)
- Prokopios P Argyris
- Division of Oral and Maxillofacial Pathology, The Ohio State University College of Dentistry, Postle Hall, Room 2191 305 W. 12th Ave, Columbus, OH, 43210, USA.
| | - Bindu Challa
- Department of Pathology, The Ohio State University Wexner Medical Center, James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Swati Satturwar
- Department of Pathology, The Ohio State University Wexner Medical Center, James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Kyle K VanKoevering
- Department of Otolaryngology-Head and Neck Surgery, The Ohio-State University Wexner Medical Center, Columbus, OH, USA
| | - Paul E Wakely
- Department of Pathology, The Ohio State University Wexner Medical Center, James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
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Branger N, Bladou F, Verhoest G, Knipper S, Robert G, Bernhard JC, Beauval JB, Khaddad A, Mauger De Varennes A, Fléchon A, Walz J, Bageot AS, Doumerc N, Rouprêt M, Murez T. Post-chemotherapy robot-assisted retroperitoneal lymph node dissection for metastatic germ cell tumors: safety and perioperative outcomes. World J Urol 2023; 41:2405-2411. [PMID: 37507528 DOI: 10.1007/s00345-023-04536-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
PURPOSE To evaluate the feasibility, safety, and early oncologic outcomes after post-chemotherapy robot-assisted retroperitoneal lymph node dissection (PC-RARPLND) for metastatic germ cell tumors (mGCT). METHODS We retrospectively analyzed patients from four tertiary centers who underwent PC-RARPLND for mGCT, from 2011 to 2021. Previous treatment of mGCT, intraoperative and postoperative complications, and early oncologic outcomes were assessed. RESULTS Overall, 66 patients were included. The majority of patients had non-seminoma mTGCT (89%). Median size of retroperitoneal lymph node (RLN) before surgery was 26 mm. Templates of PC-RARPLND were left modified, right modified, and full bilateral in 56%, 27%, and 14%, respectively. Median estimated blood loss and length of stay were 50 mL [50-150] and 2 [1-3] days. Four patients (6.1%) had a vascular injury, only one with significant blood loss and conversion to open surgery (OS). Two other patients had a conversion to OS for difficulty of dissection. No patient had transfusion, most frequent complications were ileus (10.6%) and symptomatic lymphorrea (7.6%) and no complications grade IIIb or more occurred. With a median follow-up of 16 months, two patients had a relapse, all outside of the surgical template (one in the retrocrural space with reascending markers, one in lungs). CONCLUSION PC-RARPLND is a challenging surgery. In expert centers and for selected patients, it seemed safe and feasible, with a low morbidity. Further prospective evaluation of this procedure and long-term oncologic results are needed.
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Affiliation(s)
- Nicolas Branger
- Department of Urology, Institut Paoli Calmettes Cancer Center, Marseille, France.
| | - Franck Bladou
- Department of Urology, CHU Bordeaux, Bordeaux, France
| | | | - Sophie Knipper
- Department of Urology, Institut Paoli Calmettes Cancer Center, Marseille, France
| | | | | | | | | | | | - Aude Fléchon
- Department of Oncology, Centre Léon Bérard, Lyon, France
| | - Jochen Walz
- Department of Urology, Institut Paoli Calmettes Cancer Center, Marseille, France
| | | | | | - Morgan Rouprêt
- Department of Urology, La Pitié Salpêtrière, Paris, France
| | - Thibault Murez
- Department of Urology, CHU Montpellier, Montpellier, France
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Amiri A, Krumpolec P, Mego M, Ukropcová B, Chovanec M, Ukropec J. Habitual physical activity modulates cardiometabolic health in long-term testicular cancer survivors. Support Care Cancer 2023; 31:539. [PMID: 37632597 PMCID: PMC10460370 DOI: 10.1007/s00520-023-08000-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/15/2023] [Indexed: 08/28/2023]
Abstract
PURPOSES Physical activity (PA) may mitigate late cardiometabolic toxicity of cisplatin-based chemotherapy in testicular germ cell tumor (TGCT) long-term survivors. In this cross-sectional study, we evaluated the effects of habitual PA on metabolic syndrome (MetS) prevalence, and on the markers of cardiometabolic health and chronic inflammation in a population of long-term TGCT survivors. METHODS MetS prevalence was evaluated, and habitual PA was assessed using Baecke's habitual PA questionnaire in TGCT survivors (n=195, age=41.1±8.1years, 11.7±5.2years post-therapy) and healthy male controls (n=41, age=38.2±8.8years). Participants were stratified into low- and high-PA groups based on median values. Differences were examined between low- and high-PA groups (in the entire sample, TGCT survivor sub-samples differing in disease stage, and healthy controls), and between TGCT survivors and controls. Next, TGCT survivors were stratified into age- and BMI-matched sub-groups based on post-treatment time (5-15/15/30years) and number of chemotherapy cycles (≤3/>3), allowing us to detect age- and BMI-independent effects of habitual PA on cardiometabolic health in the given TGCT survivor sub-populations. A correlation matrix of habitual PA and sport activity with cardiometabolic and pro-inflammatory markers was generated. RESULTS TGCT survivors had higher MetS prevalence than controls. Patients with high habitual PA had lower waist circumference and Systemic Inflammation Index. Habitual PA scores correlated positively with HDL-cholesterol and negatively with waist circumference and atherogenic risk. Furthermore, cardiometabolic benefits of habitual PA were more pronounced in patients with disease stages 1 and 2. Effects of habitual PA on patients sub-populations stratified by chemotherapy dose and post-treatment time clearly showed that higher levels of habitual PA were associated with lower numbers of MetS components, except for patients who received more than 3 chemotherapy cycles and were examined more than15 years post-therapy. CONCLUSIONS Higher levels of habitual PA effectively mitigated cardiometabolic toxicity in TGCT survivors. Patients with higher cumulative doses of chemotherapy may need structured exercise interventions involving higher-intensity physical activity to achieve significant improvements in cardiometabolic health.
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Affiliation(s)
- Ali Amiri
- Department of Metabolic Disease Research & Center of Physical Activity Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Patrik Krumpolec
- Department of Metabolic Disease Research & Center of Physical Activity Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Michal Mego
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Barbara Ukropcová
- Department of Metabolic Disease Research & Center of Physical Activity Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Jozef Ukropec
- Department of Metabolic Disease Research & Center of Physical Activity Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
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Brönimann S, Mun DH, Hackl M, Yang L, Shariat SF, Waldhoer T. Increase and Plateauing of Testicular Cancer Incidence in Austria-A Time Trend Analysis of the Past Four Decades. EUR UROL SUPPL 2023; 49:104-109. [PMID: 36874603 PMCID: PMC9974997 DOI: 10.1016/j.euros.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
Background Testicular germ cell tumors (TGCTs) are the most common malignant tumors in young men. Despite considerable geographic, ethnic, and temporal variations in the incidence of TGCTs, without convincing explanation, incidence rates of TGCTs have been increasing in many countries since, at least, the mid-20th century. Objective To investigate the incidence rates of TGCTs in Austria by analyzing data from the Austrian Cancer Registry. Design setting and participants Available data between 1983 and 2018 were provided by the Austrian National Cancer Registry and analyzed retrospectively. Outcome measurements and statistical analysis Germ cell tumors derived from germ cell neoplasia in situ were classified into seminomas and nonseminomas. Age-specific incidence rates and age-standardized rates were calculated. Annual percent changes (APCs) and average annual percent changes in incidence rates were determined to describe trends from 1983 to 2018. All statistical analyses were performed using SAS version 9.4 and joinpoint. Results and limitations The study population consists of 11 705 patients diagnosed with TGCTs. The median age at diagnosis was 37.7 yr. The standardized incidence rate of TGCTs increased significantly (p < 0.0001) from 4.1 (3.4, 4.8) per 100 000 in 1983 to 8.7 (7.9, 9.6) per 100 000 in 2018 by an average APC of 1.74 (1.20, 2.29). The joinpoint regression revealed a change point in time trend in 1995 with an APC of 4.24 (2.77, 5.72) before 1995 and an APC of 0.47 (0.06, 0.89) thereafter. Incidence rates were about twice as high for seminomas as for nonseminomas. A trend analysis by age group showed that the highest TGCT incidence rate was observed among men aged 30-40 yr, with a steep increase before 1995. Conclusions The incidence rate of TGCTs increased in Austria over the past decades and appears to have reached a plateau at a high level. A time trend analysis by age group for the overall incidence was highest in men aged 30-40 yr, with a steep increase before 1995. These data should lead to awareness campaigns and research to further investigate the causes of this development. Patient summary We reviewed the data between 1983 and 2018 provided by the Austrian National Cancer Registry to analyze the incidence and incidence trend in testicular cancer. Testicular cancer shows an increasing incidence in Austria. The overall incidence was highest in men aged 30-40 yr, with a steep increase before 1995. The incidence appears to have reached a plateau at a high level in recent years.
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Affiliation(s)
- Stephan Brönimann
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Dong-Ho Mun
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Monika Hackl
- Austrian National Cancer Registry, Statistics Austria, Vienna, Austria
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.,Preventive Oncology & Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.,Karl Landsteiner Institute, Vienna, Austria
| | - Thomas Waldhoer
- Centre for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
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Meng J, Gao J, Li X, Gao R, Lu X, Zhou J, Yan F, Wang H, Liu Y, Hao Z, Zhang X, Liang C. TIMEAS, a promising method for the stratification of testicular germ cell tumor patients with distinct immune microenvironment, clinical outcome and sensitivity to frontline therapies. Cell Oncol (Dordr) 2023. [PMID: 36823338 DOI: 10.1007/s13402-023-00781-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE With the heterogeneous genetic background, prognosis prediction and therapeutic targets for testicular germ cell tumors (TGCTs) are still unclear. We defined the tumor immune microenvironment activation status (TIMEAS). METHODS We collected a total of 314 TGCT patients from four cohorts, including a 48-case microarray. A nonnegative matrix factorization algorithm was applied to identify the "immune factor", derived the top 150 weighted genes to divide patients into immune and non-immune classes, and further separated the immune class into activated and exhausted subgroups by nearest template prediction. Tumor mutant burden, gene mutation, and copy number alteration were compared with our recently developed package "MOVICS". A random forest algorithm was performed to establish a prediction model with fewer genes. Immunohistochemistry staining was performed to identify TIMEAS in the microarray. RESULTS We constructed the TIMEAS in the TCGA-TGCT cohort and further validated it in the GSE3218 and GSE99420 cohorts. The immune class contained the activated status of T-lymphocytes, B-lymphocytes, and macrophages, while Treg cells and the WNT/TGFβ signature were more activated in the immune-suppressed subgroup. Patients in the immune-exhausted subgroup had the worst prognosis, and 22.9% of patients in the immune-activated subgroup had KRAS mutations, which might stimulate the response of the immune system and lead to a favorable prognosis. The immune-exhausted group benefited more from chemotherapy, while the immune-activated subgroup responded well to anti-PD-1/PD-L1 therapy. FSCN1 was validated as the target of the immune-exhausted microenvironment by immunohistochemistry. CONCLUSION TIMEAS classification can separate TGCT patients; patients in the immune-activated subgroup could benefit more from anti-PD-L1 immunotherapy, and those in the immune-exhausted subgroup are more suitable for chemotherapy.
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Li Z, Wu Y, Fu Y, Chen X, Zhao X, Wu X, Lu Y, He H, Shen C, Zheng B, Yu J, Sun F. Cyst stem cell lineage eIF5 non-autonomously prevents testicular germ cell tumor formation via eIF1A/eIF2γ-mediated pre-initiation complex. Stem Cell Res Ther 2022; 13:351. [PMID: 35883200 DOI: 10.1186/s13287-022-03025-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stem cell niche maintains stem cell population identity and is essential for the homeostasis of self-renewal and differentiation in Drosophila testes. However, the mechanisms of CySC lineage signals-mediated soma-germline communications in response to external stimuli are unclear. METHODS Pre-initiation complex functions were evaluated by UAS-Gal4-mediated cell effects. RNA sequencing was conducted in NC and eIF5 siRNA-treated cells. Genetic interaction analysis was used to indicate the relationships between eIF5 and eIF1A/eIF2γ in Drosophila testes. RESULTS Here, we demonstrated that in CySCs, translation initiation factor eIF5 mediates cyst cell differentiation and the non-autonomously affected germ cell differentiation process. CySCs lacking eIF5 displayed unbalanced cell proliferation and apoptosis, forming testicular germ cell tumors (TGCTs) during spermatogenesis. eIF5 transcriptional regulation network analysis identified multiple metabolic processes and several key factors that might be involved in germ cell differentiation and TGCT formation. Importantly, knockdown of eIF1A and eIF2γ, key components of pre-initiation complex, mimicked the phenotype of knocking down eIF5 in the stem cell niche of Drosophila testes. Genetic interaction analysis indicated that eIF5 was sufficient to rescue the phenotype of tumorlike structures induced by down-regulating eIF1A or eIF2γ in CySCs. CONCLUSIONS These findings demonstrated that CySC lineage eIF5, together with eIF1A or eIF2γ, mediates soma-germline communications for the stem cell niche homeostasis in Drosophila testes, providing new insights for the prevention of TGCTs.
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Li EC, Lai QL, Cai MT, Zheng Y, Fang GL, Fang W, Du BQ, Shen CH, Ding MP, Zhang YX. Kelch-like protein 11 antibody-associated paraneoplastic neurological syndrome: A state-of-the-art review. Clin Immunol 2022; 241:109074. [PMID: 35809856 DOI: 10.1016/j.clim.2022.109074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 11/22/2022]
Abstract
The Kelch-like protein 11 antibody-associated paraneoplastic neurological syndrome (KLHL 11-PNS) was first identified in 2019. This novel antibody, targeting the intracellular KLHL 11 antigen, can be detected in serum and cerebrospinal fluid using tissue-based and cell-based assays. It is thought to be a biomarker for a T-cell autoimmunity response. The most likely immunopathogenesis of KLHL 11-PNS appears to be linked to cytotoxic T-cell-mediated neuronal injury and loss. Patients have adult-male predilection, rhombencephalitis (brainstem and / or cerebellar involvement), and a robust oncological correlation with testicular germ cell tumors (predominately seminoma). Brain magnetic resonance imaging demonstrated T2 / fluid-attenuated inversion recovery hyperintensities and atrophy of the temporal lobe, cerebellum, and brainstem. Most patients responded poorly to immunotherapy and oncotherapy and thus had a poor long-term prognosis. We review the literature and provide an update of current knowledge regarding KLHL 11-PNS, including epidemiology, underlying mechanism, clinical presentations, paraclinical and oncological findings, diagnostic workup, and treatment approaches.
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Liu Z, Fang B, Cao J, Zhou Q, Zhu F, Fan L, Xue L, Huang C, Bo H. LINC00313 regulates the metastasis of testicular germ cell tumors through epithelial-mesenchyme transition and immune pathways. Bioengineered 2022; 13:12141-12155. [PMID: 35575252 PMCID: PMC9275957 DOI: 10.1080/21655979.2022.2073128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Testicular germ cell tumor (TGCT) is a relatively rare entity tumor, accounting for only 1% of all male cancers. However, it is the most common solid tumor in young men between 15 and 34 years old. Long noncoding RNAs (lncRNAs) are involved in various physiological and pathological processes. However, the functions of lncRNAs in TGCT have only rarely been investigated. LncRNAs associated with TGCT were identified using Gene Expression Omnibus (GEO) database and UCSC XENA database data mining. The effects of LINC00313 on NCCIT cell migration and invasion were evaluated in transwell assays. The expression levels of epithelial-mesenchyme transition (EMT)-related proteins in cells knockdown of LINC00313 were analyzed by Western blot. Correlation analyses between lncRNA LINC00313 expression and copy number variation (CNV) and immune cell infiltration were carried out using The Cancer Genome Atl as (TCGA) data. The effect of Panobinostatin targeting LINC00313 in TGCT cells was investigated. We observed higher LINC00313 expression in TGCT. The migratory and invasive properties of TGCT cells were augmented by LINC00313, likely via its effects on modulating the expression of epithelial-mesenchyme transition (EMT) related proteins: CTNNB1, ZEB1, CDH2, Snail and VIM. Moreover, LINC00313 expression and CNV correlated negatively with the infiltration of immune cells. In addition, Panobinostat might be a possible candidate drug to target LINC00313 in TGCT. LINC00313 performs important pro-migration and invasion functions in the pathogenesis of TGCT. LINC00313 could be used as diagnostic, prognostic, immune marker and therapeutic target to develop effective treatment of TGCT.
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Affiliation(s)
- Zhizhong Liu
- Department of Urology, Hunan Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.,NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Bairong Fang
- Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Jian Cao
- Department of Urology, Hunan Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Qianyin Zhou
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Fang Zhu
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Liqing Fan
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China.,Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - Lei Xue
- Department of Pathology, Hunan Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Chuan Huang
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China.,Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
| | - Hao Bo
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, Hunan, China.,Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
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Fankhauser CD, Roth L, Kranzbühler B, Eberli D, Bode P, Moch H, Oliveira P, Ramani V, Beyer J, Hermanns T. The Role of Frozen Section Examination During Inguinal Exploration in Men with Inconclusive Testicular Tumors: A Systematic Review and Meta-analysis. Eur Urol Focus 2021; 7:1400-1402. [PMID: 32684510 DOI: 10.1016/j.euf.2020.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/03/2020] [Accepted: 06/25/2020] [Indexed: 12/15/2022]
Abstract
For inconclusive testicular tumors with negative tumor markers, frozen section examination (FSE) during inguinal exploration is recommended. However, FSE is time-consuming and therefore often not requested. Furthermore, the exact diagnostic benefit remains poorly defined. We performed a systematic review and meta-analysis summarizing 12 published studies and our own series of FSE in patients with inconclusive testicular tumors, resulting in a cohort of 1052 FSEs. FSE showed sensitivity of 99% and specificity of 96% with a positive predictive value of 98% and a negative predictive value of 97%. Most importantly, one-third of all testicular tumors investigated were correctly identified as being suitable for testis-sparing surgery and orchiectomy could be avoided. For patients with inconclusive testicular tumors, FSE is useful for deciding whether testis-sparing surgery is an option or whether radical orchiectomy should be performed. Thus, these patients should be optimally treated in institutions where FSE is available. PATIENT SUMMARY: We found that intraoperative examination of a frozen section is useful in deciding on whether the entire or only parts of the testicle can be removed. We conclude that frozen section examination should be offered to men with small testicular lesions and negative tumor markers.
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Affiliation(s)
- Christian Daniel Fankhauser
- Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester, UK.
| | - Lisa Roth
- Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Benedikt Kranzbühler
- Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Daniel Eberli
- Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Peter Bode
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Pedro Oliveira
- Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester, UK
| | - Vijay Ramani
- Department of Urology, The Christie and Salford Royal NHS Foundation Trusts, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK
| | - Joerg Beyer
- University Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Hermanns
- Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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11
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Danjou AMN, Pérol O, Coste A, Faure E, Béranger R, Boyle H, Belladame E, Grassot L, Dubuis M, Spinosi J, Bouaoun L, Fléchon A, Bujan L, Drouineaud V, Eustache F, Berthaut I, Perrin J, Brugnon F, Charbotel B, Schüz J, Fervers B. Domestic use of pesticides during early periods of development and risk of testicular germ cell tumors in adulthood: a French nationwide case-control study. Environ Health 2021; 20:111. [PMID: 34706722 PMCID: PMC8554827 DOI: 10.1186/s12940-021-00795-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 10/07/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Testicular germ cell tumours (TGCT) are the most frequent cancers in young men in developed countries and their incidence rate has doubled worldwide over the past 40 years. Early life exposures to pesticides are suspected to increase TGCT risk. Our research aimed at estimating adult TGCT risk associated with parental domestic use of pesticides during early periods of child development. METHODS We conducted a case-control study of 304 TGCT cases, aged 18-45 years old, recruited in 20 French university hospitals, and 274 controls frequency-matched on hospital and birth year. Participants' mothers provided information on their domestic use of pesticides from 1 year before start of pregnancy to 1 year after their son's birth, for gardening activities, treatment of indoor plants, pets, wood and mold, and pest control. Odds ratios (OR) for TGCT (overall and by histological subtype) and 95% confidence intervals (CI) were estimated using conditional logistic regression. RESULTS Prevalence of reported domestic use of pesticides was 77.3% for insecticides, 15.9% for fungicides and 12.1% for herbicides. While no association was found for any use of insecticides (OR = 1.27, CI = 0.80-2.01) or herbicides (OR = 1.15, CI = 0.67-2.00), elevated risks of TGCT overall (OR = 1.73, CI = 1.04-2.87) and non-seminoma subtype (OR = 2.44, CI = 1.26-4.74) were observed for any use of fungicides. When specific purposes were examined, using fungicides and/or insecticides for woodwork (OR = 2.35, CI = 1.06-5.20) and using insecticides on cats and dogs (OR = 1.95, CI = 1.12-3.40) were associated with increased risk of non-seminoma subtype. We found no association for seminoma subtype. CONCLUSIONS Although recall bias may partially explain the elevated ORs, our study provides some evidence of a positive association between domestic use of pesticides during early periods of development, particularly fungicides and risk of adult TGCT and non-seminoma. Given the common domestic use of pesticides in France, further research on TGCT risk is warranted.
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Affiliation(s)
- Aurélie M. N. Danjou
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization, 150 cours Albert Thomas, 69372 Lyon, Cedex 08 France
| | - Olivia Pérol
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
| | - Astrid Coste
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
| | - Elodie Faure
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Gustave Roussy, Équipe “Exposome et Hérédité”, CESP, 94805 Villejuif, France
| | - Rémi Béranger
- IRSET (Institut de Recherche en Santé, Environnement et Travail), UMR S 1085, INSERM, EHESP, CHU Rennes, Rennes University, Rennes, France
| | - Helen Boyle
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Elodie Belladame
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
| | - Lény Grassot
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
| | - Matthieu Dubuis
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
| | - Johan Spinosi
- Direction Santé Travail, équipe associée à L’UMRESTTE (UMR T 9405 Université Lyon 1, IFSTTAR), Santé publique France, Lyon, France
| | - Liacine Bouaoun
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization, 150 cours Albert Thomas, 69372 Lyon, Cedex 08 France
| | - Aude Fléchon
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
| | - Louis Bujan
- DEFE (Développement Embryonnaire, Fertilité, Environnement) INSERM 1202 Universités Montpellier et Toulouse 3, CECOS Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
- Fédération Française des CECOS, Paris, France
| | - Véronique Drouineaud
- Fédération Française des CECOS, Paris, France
- CECOS Hôpital Cochin, Paris, France
| | - Florence Eustache
- Fédération Française des CECOS, Paris, France
- Laboratoire d’Histologie, Biologie de la Reproduction, CECOS Hôpital Tenon, Paris, France
| | - Isabelle Berthaut
- Fédération Française des CECOS, Paris, France
- Laboratoire d’Histologie, Biologie de la Reproduction, CECOS Hôpital Tenon, Paris, France
- APHP Sorbonne University, Paris, France
| | - Jeanne Perrin
- Fédération Française des CECOS, Paris, France
- CNRS, IRD, IMBE, Avignon University, Aix Marseille University, Marseille, France
- Centre Clinico-Biologique d’AMP-CECOS, AP-HM La Conception University Hospital, Marseille, France
| | - Florence Brugnon
- Fédération Française des CECOS, Paris, France
- CHU Clermont-Ferrand, CHU Estaing, AMP, CECOS, Clermont-Ferrand, France
- IMOST, INSERM U1240, Faculté Médecine Clermont-Ferrand, Clermont-Ferrand, France
| | - Barbara Charbotel
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- UMRESTTE, UMR T 9405, IFSTTAR, Lyon 1 University, Lyon University, Eiffel University, Lyon, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization, 150 cours Albert Thomas, 69372 Lyon, Cedex 08 France
| | - Béatrice Fervers
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
| | - For the TESTIS study group
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization, 150 cours Albert Thomas, 69372 Lyon, Cedex 08 France
- Département Prévention, Cancer et Environnement, Centre Léon Bérard, Lyon, France
- INSERM UMR1296 Radiation: Defense, Health, Environment, Lyon, France
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Gustave Roussy, Équipe “Exposome et Hérédité”, CESP, 94805 Villejuif, France
- IRSET (Institut de Recherche en Santé, Environnement et Travail), UMR S 1085, INSERM, EHESP, CHU Rennes, Rennes University, Rennes, France
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
- Direction Santé Travail, équipe associée à L’UMRESTTE (UMR T 9405 Université Lyon 1, IFSTTAR), Santé publique France, Lyon, France
- DEFE (Développement Embryonnaire, Fertilité, Environnement) INSERM 1202 Universités Montpellier et Toulouse 3, CECOS Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
- Fédération Française des CECOS, Paris, France
- CECOS Hôpital Cochin, Paris, France
- Laboratoire d’Histologie, Biologie de la Reproduction, CECOS Hôpital Tenon, Paris, France
- APHP Sorbonne University, Paris, France
- CNRS, IRD, IMBE, Avignon University, Aix Marseille University, Marseille, France
- Centre Clinico-Biologique d’AMP-CECOS, AP-HM La Conception University Hospital, Marseille, France
- CHU Clermont-Ferrand, CHU Estaing, AMP, CECOS, Clermont-Ferrand, France
- IMOST, INSERM U1240, Faculté Médecine Clermont-Ferrand, Clermont-Ferrand, France
- UMRESTTE, UMR T 9405, IFSTTAR, Lyon 1 University, Lyon University, Eiffel University, Lyon, France
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12
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Yu X, Han Y, Liu S, Jiang W, Song Y, Tong J, Qiao T, Lv Z, Li D. Analysis of Genetic Alterations Related to DNA Methylation in Testicular Germ Cell Tumors Based on Data Mining. Cytogenet Genome Res 2021; 161:382-394. [PMID: 34433169 DOI: 10.1159/000516385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/27/2020] [Indexed: 11/19/2022] Open
Abstract
Embryonal carcinoma (EC) and seminoma (SE) are both derived from germ cell neoplasia in situ but show big differences in growth patterns and clinical prognosis. Epigenetic regulation may play an important role in the development of EC and SE. This study investigated the DNA methylation-based genetic alterations between EC and SE by analyzing the datasets of mRNA expression and DNA methylation profiling. The datasets were downloaded from the Gene Expression Omnibus database. The differentially expressed genes (DEGs) were identified between EC and SE by limma package in R environment. Gene function enrichment analysis of the DEGs was performed on the DAVID tool, the results of which suggested differences in capability of pluripotency and genomic stability between EC and SE. The minfi package and wANNOVAR tool were used to identify differentially methylated genes. A total of 37 genes were discovered with both mRNA expression and the accordant DNA methylation changes. The findings were verified by the sequencing data from The Cancer Genome Atlas database, and Kaplan-Meier survival analysis was performed. Finally, 5 genes (PRDM1, LMO2, FAM53B, HCN4, and FAM124B) were found that showed both low expression and high methylation in EC, and were significantly associated with relapse-free survival. The findings of methylation-based genetic features between EC and SE might be helpful in studying the role of DNA methylation in cancer development.
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Affiliation(s)
- Xiaqing Yu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yali Han
- Shanghai Center of Thyroid Diseases, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Simin Liu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wen Jiang
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yingchun Song
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Junyu Tong
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tingting Qiao
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhongwei Lv
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Imaging Clinical Medical Center, Tongji University School of Medicine, Shanghai, China.,Clinical Nuclear Medicine Center, Tongji University School of Medicine, Shanghai, China
| | - Dan Li
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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13
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Symeonidis EN, Tsifountoudis I, Anastasiadis A, Mutomba WF, Kotakidou R, Hatzichristou D, Dimitriadis F. Synchronous bilateral testicular cancer with discordant histopathology occurring in a 20-year-old patient: A case report and review of the literature. Urologia 2021:3915603211028556. [PMID: 34219574 DOI: 10.1177/03915603211028556] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Bilateral testicular tumors are very rare, accounting for 1%-5% of all testicular germ-cell tumors (TGCTs). The vast majority of primary bilateral TGCTs are metachronous, with synchronous tumors comprising approximately 0.5%-1% of all cases. Those occurring synchronously share mostly the same histological pattern, predominantly seminoma, with synchronous bilateral TGCTs (SBTGCTs) with discordant subtypes being extremely rare. CASE PRESENTATION We present the case of a 20-year-old male complaining of a palpable painless right testicular mass incidentally noticed during sexual intercourse. Ultrasonography (US) and magnetic resonance imaging (MRI) of the scrotum demonstrated bilateral testicular lesions, while staging with contrast-enhanced computed tomography (CT) exhibited normal findings. Right radical orchiectomy and left testis-sparing surgery (TSS) with concomitant onco-testicular sperm extraction (onco-TESE) were initially performed. Histology of the right testis revealed a mixed germ-cell tumor, consisting of seminoma and embryonal carcinoma, while that from the left testis disclosed embryonal carcinoma and intratubular germ-cell neoplasia unclassified (IGCNU) infiltrating the surgical margins. Hence, left orchiectomy was subsequently scheduled with histology unveiling IGCNU in the greatest part of the remaining testicular parenchyma. Following adjuvant chemotherapy, with bleomycin, etoposide, and cisplatin (BEP), the patient received testosterone replacement therapy and remained free of recurrence at an 18-month follow-up. CONCLUSION This case highlights both the rarity of a bilateral testicular tumor's synchronous appearance and its extremely infrequent discordant histopathology. A comprehensive review of the major series of SBTGCTs with discordant histology cited in the literature is additionally presented.
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Affiliation(s)
- Evangelos N Symeonidis
- Department of Urology I, Aristotle University of Thessaloniki, "G. Gennimatas" General Hospital, Thessaloniki, Greece
| | - Ioannis Tsifountoudis
- Department of Radiology, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece
| | - Anastasios Anastasiadis
- Department of Urology I, Aristotle University of Thessaloniki, "G. Gennimatas" General Hospital, Thessaloniki, Greece
| | - Wilbert F Mutomba
- Department of Urology I, Aristotle University of Thessaloniki, "G. Gennimatas" General Hospital, Thessaloniki, Greece
| | - Rodoula Kotakidou
- Department of Pathology, "G. Gennimatas" General Hospital, Thessaloniki, Greece
| | - Dimitrios Hatzichristou
- Department of Urology I, Aristotle University of Thessaloniki, "G. Gennimatas" General Hospital, Thessaloniki, Greece
| | - Fotios Dimitriadis
- Department of Urology I, Aristotle University of Thessaloniki, "G. Gennimatas" General Hospital, Thessaloniki, Greece
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14
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Cheng Z, Zhang X, Bassig B, Hauser R, Holford TR, Zheng E, Shi D, Zhu Y, Schwartz SM, Chen C, Shi K, Yang B, Qian Z, Boyle P, Zheng T. Dataset of testicular germ cell tumors (TGCT) risk associated with serum polychlorinated biphenyl (PCB) by age at diagnosis and histologic types. Data Brief 2021; 36:107014. [PMID: 33937452 PMCID: PMC8076715 DOI: 10.1016/j.dib.2021.107014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/19/2021] [Accepted: 03/23/2021] [Indexed: 12/21/2022] Open
Abstract
In a population-based case control study of testicular germ cell tumors (TGCT), we reported a strong positive association between serum levels of Wolff's Group 1 (potentially estrogenic) polychlorinated biphenyl (PCBs) and risk of TGCT, and the observed associations were similar for both seminoma and non-seminoma. While the observed specific associations between TGCT and Wolff's Group 1 PCBs cannot be easily explained by bias or confounding, a question can still be asked, that is, could the relationship between PCBs and TGCT differ by age at diagnosis? PCBs tend to bioaccumulate, with more heavily chlorinated PCB congeners tending to have longer half-lives. Half-lives of PCB congeners were reported ranging from 4.6 years for PCB-28 to 41.0 years for PCB-156. The half-life for the heavy PCB congeners (17.8 years) was found to be approximately twice that for the light PCBs (9.6 years) in early studies. Therefore, the same PCB concentration measured in a 20-year-old vs. a 55-year-old is unlikely to represent the same lifetime PCB exposure or type of PCB exposure. In this analysis, we stratified the data by median age of diagnosis of TGCT and further stratified by histologic type of TGCT (seminoma vs non-seminoma) to explore if the risk of TGCT associated with PCB exposures differs by age.
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Affiliation(s)
- Zhiyuan Cheng
- School of Public Health, Brown University, Providence, RI 02903, USA
| | - Xichi Zhang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA 30322, USA
| | - Bryan Bassig
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892, USA
| | - Russ Hauser
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, MA 02115, USA
| | - Theodore R. Holford
- Department of Biostatistics, Yale School of Public Health, Yale University, CT 06510, USA
| | | | - Dian Shi
- School of Public Health, Brown University, Providence, RI 02903, USA
- School of Basic Medicine, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Yong Zhu
- Department of Biostatistics, Yale School of Public Health, Yale University, CT 06510, USA
| | - Stephen Marc Schwartz
- Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Chu Chen
- Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Kunchong Shi
- School of Public Health, Brown University, Providence, RI 02903, USA
| | - Bo Yang
- School of Public Health, Brown University, Providence, RI 02903, USA
| | - Zhengmin Qian
- Institute for Global Health & Wellbeing College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63103, USA
| | - Peter Boyle
- International Prevention and Research Institute, International Agency for Research on Cancer (IARC), Lyon 69006, France
| | - Tongzhang Zheng
- School of Public Health, Brown University, Providence, RI 02903, USA
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15
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Cheng Z, Zhang X, Bassig B, Hauser R, Holford TR, Zheng E, Shi D, Zhu Y, Schwartz SM, Chen C, Shi K, Yang B, Qian Z, Boyle P, Zheng T. Serum polychlorinated biphenyl (PCB) levels and risk of testicular germ cell tumors: A population-based case-control study in Connecticut and Massachusetts. Environ Pollut 2021; 273:116458. [PMID: 33482463 DOI: 10.1016/j.envpol.2021.116458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/24/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
The incidence rate of testicular germ cell tumors (TGCT) has continuously increased in Western countries over the last several decades. Some epidemiologic studies have reported that the endocrine disrupting polychlorinated biphenyls (PCBs) in serum may be associated with TGCT risk, but the evidence is inconsistent. Our goal was to investigate whether serum levels of PCBs are associated with the increase of TGCT risk. We conducted a population-based case-control study of 308 TGCT cases and 323 controls, all residents of Connecticut and Massachusetts. Serum levels of 56 PCBs congeners were measured using gas chromatography and unconditional logistic regression model was used to evaluate the risk of TGCT associated with total PCBs exposure, groups of PCBs categorized by Wolff's functional groups, and individual PCB congeners. The results showed that there was no association between total serum levels of PCBs and risk of TGCT overall (quartile 4 (Q4) vs. quartile 1 (Q1) odds ratio (OR) and 95% confidence interval (C.I.) = 1.0 (0.6-1.9), ρ trend = 0.9). However, strong positive association was observed between total serum levels of Wolff's Group 1 (potentially estrogenic) PCBs and risk of overall TGCT (Q4 vs. Q1 OR = 2.5, 95% CI = 1.3-4.7, ρ trend <0.05) as well as seminoma and non-seminoma subtypes. Wolff's Group 1 PCB congeners that showed an increased risk of TGCT included: 25, 44, 49, 52, 70, 101, 174, and 201/177. Considering the continuing increase of TGCT, these associations should be replicated in different populations with larger sample size.
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Affiliation(s)
- Zhiyuan Cheng
- School of Public Health, Brown University, Providence, RI, USA, 02903
| | - Xichi Zhang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA, USA, 30322
| | - Bryan Bassig
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA, 20892
| | - Russ Hauser
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, MA, USA, 02115
| | - Theodore R Holford
- Department of Biostatistics, Yale School of Public Health, Yale University, CT, USA, 06510
| | | | - Dian Shi
- School of Public Health, Brown University, Providence, RI, USA, 02903; School of Basic Medicine, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Yong Zhu
- Department of Biostatistics, Yale School of Public Health, Yale University, CT, USA, 06510
| | - Stephen Marc Schwartz
- Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, 98109
| | - Chu Chen
- Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, 98109
| | - Kunchong Shi
- School of Public Health, Brown University, Providence, RI, USA, 02903
| | - Bo Yang
- School of Public Health, Brown University, Providence, RI, USA, 02903
| | - Zhengmin Qian
- Institute for Global Health & Wellbeing College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, 63103, USA
| | - Peter Boyle
- International Prevention and Research Institute, International Agency for Research on Cancer (IARC), Lyon, 69006, France
| | - Tongzhang Zheng
- School of Public Health, Brown University, Providence, RI, USA, 02903.
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16
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Blok JM, van der Poel HG, Kerst JM, Bex A, Brouwer OR, Bosch JLHR, Horenblas S, Meijer RP. Clinical outcome of robot-assisted residual mass resection in metastatic nonseminomatous germ cell tumor. World J Urol 2020; 39:1969-1976. [PMID: 32955662 PMCID: PMC8217018 DOI: 10.1007/s00345-020-03437-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/31/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the outcome of robot-assisted residual mass resection (RA-RMR) in nonseminomatous germ cell tumor (NSGCT) patients with residual tumor following chemotherapy. PATIENTS AND METHODS Retrospective medical chart analysis of all patients with NSGCT undergoing RA-RMR at two tertiary referral centers between January 2007 and April 2019. Patients were considered for RA-RMR in case of a residual tumor between 10 and 50 mm at cross-sectional computed tomography (CT) imaging located ventrally or laterally from the aorta or vena cava, with normalized tumor markers following completion of chemotherapy, and no history of retroperitoneal surgery. RESULTS A total of 45 patients were included in the analysis. The Royal Marsden stage before chemotherapy was IIA in 13 (28.9%), IIB in 16 (35.6%), IIC in 3 (6.7%) and IV in 13 patients (28.9%). The median residual tumor size was 1.9 cm (interquartile range [IQR] 1.4-2.8; range 1.0-5.0). Five procedures (11.1%) were converted to an open procedure due to a vascular injury (n = 2), technical difficulty (n = 2) or tumor debris leakage (n = 1). A postoperative adverse event occurred in two patients (4.4%). Histopathology showed teratoma, necrosis and viable cancer in 29 (64.4%), 14 (31.1%), and two patients (4.4%), respectively. After a median follow-up of 41 months (IQR 22-70), one patient (2.2%) relapsed in the retroperitoneum. The one- and 2-year recurrence-free survival rate was 98%. CONCLUSION RA-RMR is an appropriate treatment option in selected patients, potentially providing excellent cure rates with minimal morbidity. Long-term outcome data are needed to further support this strategy and determine inclusion and exclusion criteria.
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Affiliation(s)
- Joost M Blok
- Department of Oncological Urology, University Medical Center Utrecht, Utrecht, The Netherlands. .,Department of Urology, The Netherlands Cancer Institute, Utrecht, The Netherlands.
| | - Henk G van der Poel
- Department of Urology, The Netherlands Cancer Institute, Utrecht, The Netherlands
| | - J Martijn Kerst
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Axel Bex
- Department of Urology, The Netherlands Cancer Institute, Utrecht, The Netherlands
| | - Oscar R Brouwer
- Department of Urology, The Netherlands Cancer Institute, Utrecht, The Netherlands
| | - J L H Ruud Bosch
- Department of Oncological Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Simon Horenblas
- Department of Urology, The Netherlands Cancer Institute, Utrecht, The Netherlands
| | - Richard P Meijer
- Department of Oncological Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
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17
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Kranendonk MEG, Hackeng WM, Offerhaus GJA, Morsink FHM, Jonges GN, Groenewegen G, Krijtenburg PJ, Klümpen HJ, de Leng WWJ, Looijenga LHJ, Brosens LAA. The decisive role of molecular pathology in presumed somatic metastases of type II testicular germ cell tumors: report of 2 cases. Diagn Pathol 2020; 15:99. [PMID: 32711552 PMCID: PMC7382836 DOI: 10.1186/s13000-020-01011-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/14/2020] [Indexed: 12/13/2022] Open
Abstract
Background Molecular diagnostics can be decisive in the differential diagnosis between a somatic metastasis of type II testicular germ cell tumor (TGCT) or a second primary carcinoma. This is in line with recent recommendations from the International Society of Urological Pathology, based on an international survey which showed that molecular testing is currently only performed by a minority of urological pathologists. Case presentations This case report illustrates the necessity of molecular testing in two patients with a history of type II TGCT and a metastatic (retro) peritoneal carcinoma years later. The genetic hallmark of type II TGCT, chromosome 12p gain, was studied by fluorescence in situ hybridization and whole genome methylation profiling in case 1, and by single nucleotide polymorphism (SNP)-array in case 2. Next generation sequencing (NGS) was used to further explore clonality between the primary TGCT and peritoneal metastasis in case 2. In case 1, chromosome 12p gain was found in the primary type II TGCT and in the acinar cell carcinoma of the metastatic malignancy. In case 2, SNP array showed 12p gain in the epithelial component of the primary teratomatous TGCT but not in the peritoneal adenocarcinoma. Furthermore, NGS showed no mutations in the primary teratomatous TGCT but a KRAS and GNAS mutation in the peritoneal adenocarcinoma, suggestive of an appendicular origin. Conclusions Without the molecular data, both cases would have been regarded as a metastatic TGCT with development of somatic-type malignancy, which appeared a wrong diagnosis for case 2. These cases demonstrate the importance of molecular methods as an adjunct in today’s pathology practice.
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Affiliation(s)
- Mariëtte E G Kranendonk
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.,Princess Máxima Center for Pedriatric Oncology, Utrecht, The Netherlands
| | - Wenzel M Hackeng
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - G Johan A Offerhaus
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Folkert H M Morsink
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Geertruida N Jonges
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerard Groenewegen
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Heinz-Josef Klümpen
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Wendy W J de Leng
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Lodewijk A A Brosens
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
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18
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Namekawa T, Kitayama S, Ikeda K, Horie-Inoue K, Suzuki T, Okamoto K, Ichikawa T, Yano A, Kawakami S, Inoue S. HIF1α inhibitor 2-methoxyestradiol decreases NRN1 expression and represses in vivo and in vitro growth of patient-derived testicular germ cell tumor spheroids. Cancer Lett 2020; 489:79-86. [PMID: 32544513 DOI: 10.1016/j.canlet.2020.05.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/25/2020] [Accepted: 05/29/2020] [Indexed: 12/11/2022]
Abstract
Testicular germ cell tumor (GCT) is the most common type of malignancy in young males. Patients with nonseminomatous GCT still have poor prognosis. To identify new therapeutic targets, we generated patient-derived cells (PDCs) and their xenograft (PDCX) models from 3 distinct GCT patients' specimens. The pathological features of GCT PDCs and PDCX tumors recapitulated those of nonseminomatous components exhibiting in the corresponding patients' specimens. Notably, stemness-related markers and hypoxia-related genes, including hypoxia inducible factor 1α (HIF1A) and neuritin 1 (NRN1), were abundantly expressed in three-dimensional spheroid cultures of GCT PDCs. We identified functional HIF1α response elements in the NRN1 promoter and defined that their transcriptional activities were substantially activated by hypoxia. HIF1α inhibition by siRNAs or an inhibitor, 2-methoxyestradiol, significantly suppressed NRN1 expression and decreased the in vitro and in vivo growth of PDC spheroids. Moreover, NRN1 knockdown efficiently suppressed PDC proliferation. These results suggest that HIF1α and NRN1 are potential diagnostic and therapeutic targets, and that 2-methoxyestradiol could be applied to clinical management of GCT. Overall, our GCT PDC and PDCX models would be useful as preclinical models for precision medicine targeting each patient.
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Affiliation(s)
- Takeshi Namekawa
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka, Saitama, 350-1241, Japan; Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Chiba, 260-8677, Japan
| | - Sachi Kitayama
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka, Saitama, 350-1241, Japan
| | - Kazuhiro Ikeda
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka, Saitama, 350-1241, Japan
| | - Kuniko Horie-Inoue
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka, Saitama, 350-1241, Japan
| | - Takashi Suzuki
- Department of Pathology and Histotechnology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8575, Japan
| | - Koji Okamoto
- Division of Cancer Differentiation, National Cancer Center Hospital, Chuo-ku, Tokyo, 104-0045, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Chiba, 260-8677, Japan
| | - Akihiro Yano
- Department of Urology, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, 350-8550, Japan
| | - Satoru Kawakami
- Department of Urology, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, 350-8550, Japan
| | - Satoshi Inoue
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka, Saitama, 350-1241, Japan; Department of Systems Aging Science and Medicine, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, 173-0015, Japan.
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19
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Blok JM, Meijer RP, van der Poel HG, Bex A, van Vooren J, van Urk JJ, Horenblas S, Bosch JLHR. Additional surgical procedures and perioperative morbidity in post-chemotherapy retroperitoneal lymph node dissection for metastatic testicular cancer in two intermediate volume hospitals. World J Urol 2020; 39:839-846. [PMID: 32372160 PMCID: PMC7969692 DOI: 10.1007/s00345-020-03229-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/24/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose To evaluate the perioperative morbidity of PC-RPLND in two intermediate volume centers and to identify predictors of high morbidity. Methods Retrospective analysis of 124 patients treated with open PC-RPLND at two tertiary referral centers between 2001 and 2018. Perioperative morbidity was determined by analyzing additional surgical procedures, intra-operative blood loss, and postoperative complications. Results An additional procedure was necessary for 33 patients (26.6%). The risk was higher in patients with IGCCCG intermediate/poor prognosis (OR 3.56; 95% CI 1.33–9.52) and residual tumor size > 5 cm (OR 3.53; 95% CI 1.39–8.93). Blood loss was higher in patients with IGCCCG intermediate/poor prognosis (β = 0.177; p = 0.029), large residual tumor (β = 0.570; p < 0.001), an additional intervention (β = 0.342; p < 0.001) and teratoma on retroperitoneal histology (β = − 0.19; p = 0.014). Thirty-one patients had a postoperative complication Clavien-Dindo Grade ≥ 2 (25.0%). Complication risk was highest in patients undergoing an additional intervention (OR 3.46; 95% CI 1.03–11.60; p = 0.044). Conclusions The rate of additional interventions in our series is comparable to what has been reported in high-volume centers. IGCCCG intermediate/poor prognosis patients with high-volume disease and patients undergoing an additional surgical procedure can be classified as high-risk patients. Electronic supplementary material The online version of this article (10.1007/s00345-020-03229-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joost M Blok
- Department of Oncological Urology, University Medical Center Utrecht, Utrecht, The Netherlands. .,Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - Richard P Meijer
- Department of Oncological Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Henk G van der Poel
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Axel Bex
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeanette van Vooren
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Japke J van Urk
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Simon Horenblas
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J L H Ruud Bosch
- Department of Oncological Urology, University Medical Center Utrecht, Utrecht, The Netherlands
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20
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Haarsma R, Blok JM, van Putten K, Meijer RP. Clinical outcome of post-chemotherapy retroperitoneal lymph node dissection in metastatic nonseminomatous germ cell tumour: A systematic review. Eur J Surg Oncol 2020; 46:999-1005. [PMID: 32173176 DOI: 10.1016/j.ejso.2020.02.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/24/2020] [Accepted: 02/22/2020] [Indexed: 01/11/2023] Open
Abstract
Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) is an important element of the management of patients with residual tumour after chemotherapy for disseminated nonseminomatous germ cell tumour (NSGCT). This is a challenging procedure and the outcome varies widely between institutions. There is much debate concerning the anatomical extent of the dissection and the literature is conflicting regarding the outcome of this procedure. In this systematic review we aim to summarise the literature on the relapse rate of PC-RPLND. We performed a search of the literature of the PubMed/MEDLINE and Embase databases, in accordance with the PRISMA guidelines. Studies reporting on the relapse rate of PC-RPLND in NSGCT patients with residual tumour were eligible for inclusion. We calculated the weighted average relapse rates of included studies and assessed the risk of bias using the Newcastle-Ottawa scale. A total of 33 studies, reporting on 2,379 patients undergoing open PC-RPLND (O-RPLND) and 463 patients undergoing minimally invasive PC-RPLND (MI-RPLND) were included. The weighted average relapse rates were 11.4% for O-RPLND, and 3.0% for MI-RPLND. The rates of retroperitoneal relapse were 4.6% and 1.7% after O-RPLND and MI-RPLND, respectively. For O-RPLND specifically, the average retroperitoneal relapse rate was 3.1% after modified dissection and 6.1% after bilateral dissection. We conclude that modified template dissection is oncologically safe in carefully selected patients. Minimally invasive procedures are feasible but long-term data on the oncological outcome are still lacking. PC-RPLND is a complex and challenging procedure, and patients should be treated at high-volume expert centres.
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21
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Chanal E, Bouleftour W, Guillot A, Rowinski E, Bernichon E, Tremeau L, Lardon R, Lacroix B, Lorin S, Delorme G, Perraud Y, Armand C, Levigne F, Vallard A, Langrand-Escure J, Fournel P, Benoite M, Vassal C. Current management of stage I testicular germ cell tumors in a French cancer institute. A practice analysis over the 10 past years. Bull Cancer 2019; 106:1086-1093. [PMID: 31582176 DOI: 10.1016/j.bulcan.2019.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/01/2019] [Accepted: 08/13/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Testicular Germ Cell Tumors (TGCTs) represent the most frequent malignant tumour among young male adults. Orchiectomy alone cure 80% of stage I. Standard options after orchiectomy include radiotherapy (RT), chemotherapy (CT) by 1 cycle of carboplatin AUC 7 or active surveillance (SV) for seminomatous GCTs (SGCT) and retroperitoneal lymphadenectomy (RPLND), CT by 1 or 2 cycles of Bleomycine Etoposide Cisplatine (BEP) or active surveillance for nonseminomatous GCTs (NSGCT). Adjuvant treatments decrease the relapse rate after orchiectomy with substantial toxicities without any benefit on overall survival. Recent guidelines accorded utmost importance on SV rather than adjuvants strategies. The main objective of this study was to describe our current practice over the 10 past years in regard of these recommendations. METHODS Data of 50 patients with stage I GCT treated in our institute were collected between 2006 and 2016. Demographic and anatomopathologic data were reported. Clinical practice in our center was analyzed during two periods [2006-2011] and [2012-2016] according to the European Association of Urology Guidelines in 2011. RESULTS Patient's median age was 35.3 years. The analysis of clinical practice during the last 10 years showed that in SGCT, main treatment was RT than SV and CT. This option declined over the years (89% between 2006-2010 versus 53% between 2011-2016) whereas SV was more often employed (27% between 2011-2016 versus none between 2006-2010). Surveillance was used for 64% of NSGCT. CONCLUSIONS In our center, RT was less used over the years for the benefit of SV which is recommended by guidelines.
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Affiliation(s)
- Edouard Chanal
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Wafa Bouleftour
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France.
| | - Aline Guillot
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Elise Rowinski
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Emilie Bernichon
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | | | - Renaud Lardon
- Clinique mutualiste chirurgicale de Saint-Étienne, Urology department, Saint-Étienne, France
| | - Bertrand Lacroix
- Clinique mutualiste chirurgicale de Saint-Étienne, Urology department, Saint-Étienne, France
| | - Stephane Lorin
- Hôpital Privé de la Loire, Urology department, Loire, France
| | - Gregory Delorme
- Hôpital Privé de la Loire, Urology department, Loire, France
| | - Yves Perraud
- Hôpital Privé de la Loire, Urology department, Loire, France
| | - Corinne Armand
- Hôpital Privé de la Loire, Urology department, Loire, France
| | | | - Alexis Vallard
- Institut de cancérologie Lucien-Newirth, Department of Radiotherapy, Saint-Priest-en-Jarez, France
| | - Julien Langrand-Escure
- Institut de cancérologie Lucien-Newirth, Department of Radiotherapy, Saint-Priest-en-Jarez, France
| | - Pierre Fournel
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Mery Benoite
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
| | - Cecile Vassal
- Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France
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22
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Fankhauser CD, Roth L, Grossmann NC, Kranzbühler B, Eberli D, Sulser T, Moch H, Bode PK, Beyer J, Hermanns T. CXCL12 expression is an adverse predictor for disease recurrence in patients with metastatic non-seminomatous testicular germ cell tumors. BMC Cancer 2019; 19:802. [PMID: 31412792 PMCID: PMC6693197 DOI: 10.1186/s12885-019-5961-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/19/2019] [Indexed: 11/13/2022] Open
Abstract
Background To validate the utility of the chemokine ligand 12 (CXCL12) as prognostic marker in patients with localized and metastatic germ cell tumors (GCT). Methods CXCL12 expression was analyzed on a tissue microarray consisting of 750 tissue cores of different histological tumor components, Germ cell neoplasia in situ (GCNIS) and adjacent normal tissue of 263 testicular cancer patients using a semi-quantitative score. The association between CXCL12 expression and recurrence-free survival (RFS) as well as overall survival (OS) was assessed using Kaplan-Meier curves with log-rank tests. Results CXCL12 expression was absent in all seminomas but was found in 52 of 99 (52.5%) non-seminomas. Follow-up was available for 260 patients of which 36 (13.8%) recurred. In patients with stage 1 non-seminoma GCT, CXCL12 expression was not associated with higher risk of disease recurrence (p = 0.270). In contrast, post chemotherapy RFS of patients with metastatic non-seminoma and positive CXCL12 expression was significantly shorter compared to CXCL12 negative patients (p = 0.003). OS differences were not statistically different between patients with CXCL12 positive or negative tumors for either localized or metastatic disease. Conclusions CXCL12 is almost exclusively expressed in non-seminoma. Pure seminoma, GCNIS and adjacent normal testicular tissue are CXCL12 negative. Our analysis suggests that patients with metastatic disease and a CXCL12-positive non-seminoma are at higher risk for disease recurrence after first-line chemotherapy and might thus be candidates for more intensive treatment and/or closer follow-up.
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Affiliation(s)
| | - Lisa Roth
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Benedikt Kranzbühler
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Daniel Eberli
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Tullio Sulser
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Holger Moch
- Department of Pathology of Molecular Pathology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Peter-Karl Bode
- Department of Pathology of Molecular Pathology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Joerg Beyer
- Department of Oncology, University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Hermanns
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
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23
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Yeste-Velasco M, Guo T, Mao X, Stankiewicz E, Scandura G, Li H, Wang CS, Kudahetti S, Oliver T, Berney D, Shamash J, Lu YJ. The potential of brentuximab vedotin, alone or in combination with current clinical therapies, in the treatment of testicular germ cell tumors. Am J Cancer Res 2019; 9:855-871. [PMID: 31218098 PMCID: PMC6556605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023] Open
Abstract
Testicular germ cell tumors (TGCTs) are the commonest tumors in young men. With the advancement of chemotherapies, most TGCTs are successfully cured, even when diagnosed at an advanced and metastatic stage. However, a proportion of often young patients, median age 35-40, with advanced disease are not cured and will inevitably die. Therefore, there is an unmet need in this small population of young patients who are candidates for experimental approaches. We investigated a new therapeutic option for this group of patients, aiming to significantly improve their outcome. In recent years, many targeted therapies have been developed which demonstrated high efficacy and low toxicity. Brentuximab vedotin, a monomethyl auristatin E conjugated CD30 antibody, targets CD30 to kill cancer cells. As a large proportion of TGCTs express CD30, in particular embryonal carcinomas, we investigated in vitro the efficacy of brentuximab vedotin in treating TGCTs as a single therapy and in combination with commonly used chemotherapy drugs. We determined CD30 expression levels in 12 TGCT cell lines, including three cisplatin resistant sublines. In general, the efficiency of cancer cell inhibition by brentuximab vedotin correlates with CD30 expression, but there were some exceptions. We also determined the efficacy of brentuximab vedotin in combination with commonly used chemotherapy drugs and found synergistic/additive effects with etoposide, paclitaxel and SN-38. However, cisplatin, the most commonly used chemotherapy drug in TGCT treatment, exhibited antagonism and we showed that cisplatin selectively kills CD30 positive cells. We also found that certain agents, which have been reported to induce CD30 expression in other human malignant diseases, including DNA demethylation drugs, methotrexate and CD30 ligands, were unable to enhance CD30 expression or brentuximab vedotin efficacy in TGCT cells. This study will help to design clinical trials using brentuximab vedotin for the treatment of TGCTs, either as a single agent or in combination with current clinical therapies.
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Affiliation(s)
- Marc Yeste-Velasco
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Tianyu Guo
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Xueying Mao
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Elzbieta Stankiewicz
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Glenda Scandura
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Haibo Li
- St George’s University of LondonLondon, UK
| | - Claire S Wang
- Gonville and Caius College, University of CambridgeUK
| | - Sakunthala Kudahetti
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Tim Oliver
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Daniel Berney
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Jonathan Shamash
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
| | - Yong-Jie Lu
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of LondonLondon, UK
- Department of Urology, Affiliated Wuxi No. 2 Hospital of Nanjing Medical UniversityWuxi, China
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24
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Abstract
Serum tumor markers (STMs) play a critical role in the diagnosis, staging and follow-up of both seminomatous and nonseminomatous testicular germ cell neoplasms. Levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH), especially those measured after orchiectomy, also have implications for patient prognosis. Given that testicular germ cell tumors represent the most common solid tumor in men aged 20-34, radiologists must have familiarity with the clinical utilization and implications of these STMs. This article will review the classical patterns of STM elevation most commonly seen in pure seminomatous and nonseminomatous germ cell tumors while also providing case-based examples highlighting the importance of STM correlation with imaging. The role of STMs in clinical staging and disease surveillance will also be discussed.
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Affiliation(s)
- Colin Marshall
- University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Michael Enzerra
- University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
| | - Amir Ata Rahnemai-Azar
- University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Nikhil H Ramaiya
- University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
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25
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Fankhauser CD, Gerke TA, Roth L, Sander S, Grossmann NC, Kranzbühler B, Eberli D, Sulser T, Beyer J, Hermanns T. Pre-orchiectomy tumor marker levels should not be used for International Germ Cell Consensus Classification (IGCCCG) risk group assignment. J Cancer Res Clin Oncol 2019; 145:781-785. [PMID: 30637464 DOI: 10.1007/s00432-019-02844-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 01/08/2019] [Indexed: 01/17/2023]
Abstract
PURPOSE To investigate whether the use of pre-orchiectomy instead of pre-chemotherapy tumor marker (TM) levels has an impact on the International Germ Cell Consensus Classification (IGCCCG) risk group assignment in patients with metastatic germ cell tumors (GCT). METHODS Demographic and clinical information of all patients treated for primary metastatic testicular non-seminomatous GCT in our tertiary care academic center were extracted from medical charts. IGCCCG risk group assignment was correctly performed with pre-chemotherapy marker levels and additionally with pre-orchiectomy marker levels. Agreement between pre-chemotherapy and pre-orchiectomy risk group assignments was assessed using Cohen's kappa. RESULTS Our cohort consisted of 83 patients. The use of pre-orchiectomy TMs resulted in an IGCCCG risk group upstaging in 12 patients (16%, 8 patients from good to intermediate risk and 4 patients from intermediate to poor risk) and a downstaging in 1 patient (1.2%, from intermediate- to good-risk). The agreement between pre-orchiectomy and pre-chemotherapy IGCCCG risk groups resulted in a Cohen's kappa of 0.888 (p < 0.001). CONCLUSIONS Using pre-orchiectomy TMs can result in incorrect IGCCCG risk group assignment, which in turn can impact on the clinical management and follow-up of patients with metastatic GCT. Thus, adherence to the IGCCCG standard using pre-chemotherapy TMs levels is recommended.
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Affiliation(s)
| | - Travis A Gerke
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, USA
| | - Lisa Roth
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Sophia Sander
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Benedikt Kranzbühler
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Daniel Eberli
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Tullio Sulser
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
| | - Joerg Beyer
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
| | - Thomas Hermanns
- Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland
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26
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Zhou J, Xia S, Li T, Liu R. Association between male pattern baldness and testicular germ cell tumor: a meta-analysis. BMC Cancer 2019; 19:53. [PMID: 30634927 PMCID: PMC6329191 DOI: 10.1186/s12885-018-5197-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/09/2018] [Indexed: 12/04/2022] Open
Abstract
Background The relationship between male pattern baldness and incidence of testicular cancer remains inconclusive. Hence, we performed the present meta-analysis based on all eligible case–control studies. Methods A comprehensive literature search was performed in July 30th 2018 based on PUBMED, EMBASE and Web of science database. Pooled odds ratio(OR) and its 95% confidence intervals (95% CIs) was calculated with a DerSimonian and Laird random-effects. Results The pooled results were included in this meta-analysis. Overall, We have demonstrated statistically signification between baldness(any pattern) and testicular cancer was identified (OR: 0.61, 95% CI:0.50–0.74). There was no obvious heterogeneity across included studies (P = 0.22 for heterogeneity, I2 = 30%). When subgroup analysis by types of baldness, We found a statistically significant association was observed that baldness(I-VII) might become a protective factor for the risk of testicular germ cell tumor(TGCT). There was no definite connection between alopecia and the different types of TGCT. Conclusion Individuals with any pattern baldness may have a decreased risk of testicular cancer, all of analyses studies are warranted to confirm our preliminary findings. According to subgroup analysis of different hair loss grades, we found that 2 stage(II) hair loss can decrease more strongly testicular cancer risk than any other grades. Despite of our findings, We still need further researches to advance knowledge in this field.
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Affiliation(s)
- Jiatong Zhou
- The Second Hospital of Tianjin Medical University, Department of Urology, Tianjin Institute of Urology, No. 23 Pingjiang Road, Hexi District, Tianjin, People's Republic of China
| | - Shuai Xia
- The Second Hospital of Tianjin Medical University, Department of Urology, Tianjin Institute of Urology, No. 23 Pingjiang Road, Hexi District, Tianjin, People's Republic of China
| | - Tao Li
- The Second Hospital of Tianjin Medical University, Department of Urology, Tianjin Institute of Urology, No. 23 Pingjiang Road, Hexi District, Tianjin, People's Republic of China
| | - Ranlu Liu
- The Second Hospital of Tianjin Medical University, Department of Urology, Tianjin Institute of Urology, No. 23 Pingjiang Road, Hexi District, Tianjin, People's Republic of China.
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Bremmer F. [Identification of diagnostic tumour markers and therapeutic targets in testicular tumours]. Pathologe 2018; 39:215-20. [PMID: 30206653 DOI: 10.1007/s00292-018-0493-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Today, tumour classification has been expanded due to immunohistochemical and molecular-pathological analyses due to corresponding patterns/profiles of protein and gene expression. The latter analyses often include growth factors and their ligands, intracellular signalling pathways, DNA-binding proteins, and oncogenes and suppressor genes, thus functionally including primarily the regulation of growth including angiogenesis and apoptosis as well as the induction of metastases to adhesion and migration disorders. Based on observations that testicular tumours often show microcalcifications, possibly due to impaired calcium metabolism, we focused on calcium-dependent transmembrane proteins, particularly cadherins, in the search for new tumour markers and therapeutic targets. N‑cadherin is expressed differently in the various subtypes of germ cell tumours and is useful in N‑cadherin-positive germ cell tumours as a novel therapeutic targeting structure, particularly in cisplatin resistance, due to functional analysis. In the tumours of the sex cord stroma beta-catenin and the transcription factor SOX-9 give a clear classification of these tumours. Thus, morphological investigations prove to be pilot experiments to purposefully narrow the spectrum of functionally important proteins and thus to establish promising new differential diagnostic markers or target structures.
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28
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Zhang T, Ji L, Liu B, Guan W, Liu Q, Gao Y. Testicular germ cell tumors: a clinicopathological and immunohistochemical analysis of 145 cases. Int J Clin Exp Pathol 2018; 11:4622-4629. [PMID: 31949861 PMCID: PMC6962990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/31/2018] [Indexed: 06/10/2023]
Abstract
Testicular germ cell tumor (TGCT) is the most common tumor usually occuring in males between 20-40 years old. In recentyears, the incidence of TGCTs has risen markedly. The outcome depends on its pathologic type and tumor stage. This study was a retrospective analysis of the clinicopathological and immunohistochemical of 145 TGCTs. According to our findings, teratoma, both mature and immature, mostly involved children, as did yolk sac tumor. Patients under 18 years old all survived for at least five years, while the mortality rate was 87.8% after five years since surgery and 96.5% in adults after three years. There was no difference between the survival rate of seminomatous tumor and non-seminomatous tumor. We also analyzed two routine diagnostic markers-PLAP and OCT4 on all TGCT tissues. Results showed that OCT4 may be a better predictive marker than PLAP to distinguish the TGCTS. Our finding suggested that TGCTs mostly occurred in young adult, and the mortality of those who under 18 years old is lower than the adult patients. However in distinguishing the seminoma tumor from non-seminoma tumor, new marker should be further study.
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Affiliation(s)
- Ting Zhang
- Department of Assisted Reproduction, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai, China
| | - Lixuan Ji
- Department of Assisted Reproduction, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai, China
| | - Bin Liu
- Department of Assisted Reproduction, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai, China
| | - Wenbin Guan
- Department of Pathology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai, China
| | - Qiang Liu
- Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of MedicineShanghai, China
| | - Yuping Gao
- Department of Assisted Reproduction, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai, China
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Liang W, Song L, Peng Z, Zou Y, Dai S. Possible association between androgenic alopecia and risk of prostate cancer and testicular germ cell tumor: a systematic review and meta-analysis. BMC Cancer 2018. [PMID: 29529997 PMCID: PMC5848631 DOI: 10.1186/s12885-018-4194-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A number of studies have investigated the association between androgenic alopecia (AGA) and cancer risk, but they have yielded inconsistent results. Therefore, this study was conducted to explore this controversial subject. METHODS A literature database search was performed according to predefined criteria. An odds ratio (OR) or a hazard ratio (HR) with 95% confidence intervals (CIs) was retained to evaluate the relationship between the incidence of cancer or cancer-specific mortality and categories of AGA. Then a pooled OR or HR was derived. RESULTS The pooled results showed that no specific degree of baldness had an influence on the incidence of cancer or cancer-specific mortality. However, AGA, especially frontal baldness, with the incidence of testicular germ cell tumor (TGCT) (OR = 0.69; 95% CI = 0.58-0.83). A significant increase of risk was observed in relation to high grade prostate cancer (PC) (OR = 1.42; 95% CI 1.02-1.99) and vertex with/without frontal baldness was associated with PC risk. CONCLUSIONS The study results supported the hypothesis that AGA is negatively associated with TGCT risk and suggested an overlapping pathophysiological mechanism between them, while the viewpoint that AGA can be used as a phenotypic marker for PC risk was poorly supported.
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Affiliation(s)
- Weijun Liang
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China
| | - Liuying Song
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China
| | - Zheng Peng
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China
| | - Yan Zou
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China
| | - Shengming Dai
- Department of Clinical Laboratory, the Fourth Affiliated Hospital of Guangxi Medical University, No.1 Liushi Road, Liuzhou, Guangxi Zhuang Autonomous Region, 545005, People's Republic of China.
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30
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Gainetdinov IV, Skvortsova YV, Kondratieva SA, Klimov A, Tryakin AA, Azhikina TL. Assessment of piRNA biogenesis and function in testicular germ cell tumors and their precursor germ cell neoplasia in situ. BMC Cancer 2018; 18:20. [PMID: 29301509 DOI: 10.1186/s12885-017-3945-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 12/20/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Aberrant overexpression of PIWI/piRNA pathway proteins is shown for many types of tumors. Interestingly, these proteins are downregulated in testicular germ cell tumors (TGCTs) compared to normal testis tissues. Here, we used germline and TGCT markers to assess the piRNA biogenesis and function in TGCTs and their precursor germ cell neoplasia in situ (GCNIS). METHODS We used small RNA deep sequencing, qRT-PCR, and mining public RNAseq/small RNA-seq datasets to examine PIWI/piRNA gene expression and piRNA biogenesis at four stages of TGCT development: (i) germ cells in healthy testis tissues, (ii) germ cells in testis tissues adjacent to TGCTs, (iii) GCNIS cells and (iv) TGCT cells. To this end, we studied three types of samples: (a) healthy testis, (b) testis tissues adjacent to two types of TGCTs (seminomas and nonseminomas) and containing both germ cells and GCNIS cells, as well as (c) matching TGCT samples. RESULTS Based on our analyses of small RNA-seq data as well as the presence/absence of expression correlation between PIWI/piRNA pathway genes and germline or TGCT markers, we can suggest that piRNA biogenesis is intact in germ cells present in healthy adult testes, and adjacent to TGCTs. Conversely, GCNIS and TGCT cells were found to lack PIWI/piRNA pathway gene expression and germline-like piRNA biogenesis. However, using an in vitro cell line model, we revealed a possible role for a short PIWIL2/HILI isoform expressed in TGCTs in posttranscriptional regulation of the youngest members of LINE and SINE classes of transposable elements. Importantly, this regulation is also implemented without involvement of germline-like biogenesis of piRNAs. CONCLUSIONS Though further studies are warranted, these findings suggest that the conventional germline-like PIWI/piRNA pathway is lost in transition from germ cells to GCNIS cells.
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31
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Boudaoud N, Loron G, Pons M, Landais E, Kozal S, Doco-Fenzy M, Poli-Merol ML. Bilateral methachronous testicular germ cell tumor and testicular microlithiasis in a child: Genetic analysis and insights. A case report. Int J Surg Case Rep 2017; 41:76-79. [PMID: 29040905 PMCID: PMC5645006 DOI: 10.1016/j.ijscr.2017.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To report our experience with a case of a child with bilateral testicular micro-lithiasis (TML) who developed bilateral metachronous testicular germ cell tumor (TGCT) and determine the most appropriate follow-up and care management in children with testicular micro calcifications in regards to the theoretical risk of testicular cancer. CASE REPORT A 12 year-old boy was diagnosed with TGCT and TML. Ten years after complete remission, he presented with a recurrence on the contralateral testis. Genetic screening was performed on both resected and the patient's karyotype was analyzed. RESULTS Blood karyotype was normal. Aberrations were found in the tumor karyotype. CGH array showed alterations in chromosome arm 12p. DISCUSSION TML is frequently associated with testicular malignancy in adults: in 16.9% of cases the normal contralateral testicle develops TML in TGCT. Recent works of literature find no relationship between TML and cancer in general, but in patients with additional risks, the relationship becomes stronger. Some authors suggest that environmental components and genetics are determinant factors. This is highly suspected in our reported case. It would seem that TML is not a precancerous lesion per se, but rather a marker of an at-risk situation. Long term evolution is uncertain and regular self-palpation that starts before puberty is the only way to ensure proper screening and monitoring. CONCLUSION TML have been suspected to be a sign of testicular dysgenesis syndrome, which yields a risk of developing TGCT in case of noxious associations. In patients with a history of TGCT contralateral TML is alarming and aggressive surgical management should be discussed. Therapeutic education of these patients on self-palpation is the best way to ensure proper follow-up.
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Affiliation(s)
- N Boudaoud
- Department of Pediatric Surgery, American Memorial Hospital, CHU REIMS, France
| | - G Loron
- Department of Pediatrics, American Memorial Hospital, CHU REIMS, France
| | - M Pons
- Department of Pediatric Surgery, American Memorial Hospital, CHU REIMS, France
| | - E Landais
- Genetic Department, CHU-Reims, SFR-CAP Santé, UFR Médecine Reims, EA 3801, France
| | - S Kozal
- Department of Pediatric Surgery, American Memorial Hospital, CHU REIMS, France
| | - M Doco-Fenzy
- Genetic Department, CHU-Reims, SFR-CAP Santé, UFR Médecine Reims, EA 3801, France
| | - M L Poli-Merol
- Department of Pediatric Surgery, American Memorial Hospital, CHU REIMS, France.
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Wang ML, McHugh JB, Weizer AZ, Morgan TM, Chinnaiyan AM, Sciallis AP, Lagstein A, Spratt DE, Mehra R. Rare Presentation of Metastatic Cystic Trophoblastic Tumor in a Patient Without Prior Chemotherapy. Urol Case Rep 2017; 13:154-157. [PMID: 28567335 DOI: 10.1016/j.eucr.2017.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 04/24/2017] [Accepted: 04/26/2017] [Indexed: 11/25/2022] Open
Abstract
Cystic trophoblastic tumor (CTT) is a rare testicular germ cell tumor (GCT) predominantly seen in post-chemotherapy patients. It is prognostically similar to teratoma and requires no additional chemotherapy in the absence of a nonteratomatous GCT component. We report a case of metastatic CTT in a patient with primary testicular teratoma without prior chemotherapy. Retroperitoneal lymph node metastases contained teratoma, embryonal carcinoma, and CTT. The CTT was β-hCG positive and SALL4 negative by immunohistochemistry (IHC). CTT can arise in metastatic testicular GCT in treatment naïve patients. An important differential diagnosis is choriocarcinoma due to treatment implications, and SALL4 IHC may help.
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Affiliation(s)
- Michael L Wang
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jonathan B McHugh
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Alon Z Weizer
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Todd M Morgan
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Arul M Chinnaiyan
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Andrew P Sciallis
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Amir Lagstein
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel E Spratt
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.,Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
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Tariba B, Živković T, Filipović Marijić V, Erk M, Gamulin M, Pizent A. Does the Serum Metallothionein Level Reflect the Stage of Testicular Germ Cell Tumor? Arch Med Res 2016; 47:232-5. [PMID: 27255355 DOI: 10.1016/j.arcmed.2016.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
Abstract
Increased levels of metallothionein (MT) have recently been found in the blood serum of men with newly diagnosed testicular germ cell tumors (TGCT). In light of previously published results, the aim of this study was to investigate the difference in serum MT levels among patients with different stages of TGCT and compare MT with commonly used markers (α-fetoprotein, β-human chorionic gonadotropin and lactate dehydrogenase). The concentration of total MT was determined in the serum of 25 men with TGCT (seminoma or non-seminoma) by differential pulse voltammetry. Serum samples were obtained prior to chemotherapy, after two cycles of chemotherapy and 1 year after chemotherapy. A statistically significant difference in MT levels in patients with different stages of TGCT was observed in the serum of patients with non-seminoma obtained before chemotherapy. Although not significant, an increase in serum MT levels commensurate with the disease stage increase was also observed in patients with seminomatous TGCT. The results indicate that, in combination with the existing markers, MT could be useful for the identification of the histological type of tumor and stage of the disease before biopsy diagnosis.
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Affiliation(s)
- Blanka Tariba
- Analytical Toxicology and Mineral Metabolism Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | - Tanja Živković
- Analytical Toxicology and Mineral Metabolism Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Vlatka Filipović Marijić
- Laboratory for Biological Effects of Metals, Division for Marine and Environmental Research, Ruđer Bošković Institute, Zagreb, Croatia
| | - Marijana Erk
- Laboratory for Biological Effects of Metals, Division for Marine and Environmental Research, Ruđer Bošković Institute, Zagreb, Croatia
| | - Marija Gamulin
- Department of Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Alica Pizent
- Analytical Toxicology and Mineral Metabolism Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
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Sedaghat N, Fathy M, Modarressi MH, Shojaie A. Identifying functional cancer-specific miRNA-mRNA interactions in testicular germ cell tumor. J Theor Biol 2016; 404:82-96. [PMID: 27235586 DOI: 10.1016/j.jtbi.2016.05.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 04/26/2016] [Accepted: 05/19/2016] [Indexed: 12/30/2022]
Abstract
Testicular cancer is the most common cancer in men aged between 15 and 35 and more than 90% of testicular neoplasms are originated at germ cells. Recent research has shown the impact of microRNAs (miRNAs) in different types of cancer, including testicular germ cell tumor (TGCT). MicroRNAs are small non-coding RNAs which affect the development and progression of cancer cells by binding to mRNAs and regulating their expressions. The identification of functional miRNA-mRNA interactions in cancers, i.e. those that alter the expression of genes in cancer cells, can help delineate post-regulatory mechanisms and may lead to new treatments to control the progression of cancer. A number of sequence-based methods have been developed to predict miRNA-mRNA interactions based on the complementarity of sequences. While necessary, sequence complementarity is, however, not sufficient for presence of functional interactions. Alternative methods have thus been developed to refine the sequence-based interactions using concurrent expression profiles of miRNAs and mRNAs. This study aims to find functional cancer-specific miRNA-mRNA interactions in TGCT. To this end, the sequence-based predicted interactions are first refined using an ensemble learning method, based on two well-known methods of learning miRNA-mRNA interactions, namely, TaLasso and GenMiR++. Additional functional analyses were then used to identify a subset of interactions to be most likely functional and specific to TGCT. The final list of 13 miRNA-mRNA interactions can be potential targets for identifying TGCT-specific interactions and future laboratory experiments to develop new therapies.
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Affiliation(s)
- Nafiseh Sedaghat
- Computer Engineering School, Iran University of Science and Technology, Iran
| | - Mahmood Fathy
- Computer Engineering School, Iran University of Science and Technology, Iran
| | | | - Ali Shojaie
- Department of Biostatistics, University of Washington, United States
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Abstract
Intratubular germ cell neoplasia (ITGCN) is a precursor lesion for testicular germ cell tumors, most of which are early stage. ITGCN is also associated with testicular cancer or ITGCN in the contralateral testis, leading to a risk of bilateral testicular malignancy. Testicular biopsy detects most cases, and orchiectomy is the treatment of choice in patients with unilateral ITGCN. Low-dose radiation therapy is recommended in patients with bilateral ITGCN or ITGCN in the solitary testis, but the long-term risks of infertility and hypogonadism need to be discussed with the patient. Rare histologies of primary testicular cancer are also discussed.
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Affiliation(s)
- Pranav Sharma
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Jasreman Dhillon
- Department of Genitourinary Anatomic Pathology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Wade J Sexton
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
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Abstract
Prepubertal testicular tumors are rare compared with postpubertal testicular tumors. The incidence of prepubertal testicular tumors peaks at 2 years of age, tapers off after 4 years of age, and then begins to rise again at puberty. Prepubertal and postpubertal testicular tumors show many differences, including the typical tumor histology, molecular biological differences, and the malignant potential of tumors at different ages. Pediatric testicular tumors are classified as benign or malignant on the basis of their clinical behavior and histologically are divided into germ cell and gonadal stromal (nongerm cell) tumors. Many histological and biological studies have further confirmed the distinct nature of prepubertal and postpubertal testicular tumors. These differences have led to various management strategies for prepubertal and postpubertal tumors. Because overall about 75% of prepubertal testicular tumors are benign, a testis-sparing approach is becoming more common in children. Orchiectomy and observation with very selective use of chemotherapy has become the standard approach when a malignant tumor is identified. Retroperitoneal lymph node dissection and radiation therapy play very limited roles.
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Affiliation(s)
- Jae Min Chung
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
| | - Sang Don Lee
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
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Kratz CP, Edelman DC, Wang Y, Meltzer PS, Greene MH. Genetic and epigenetic analysis of monozygotic twins discordant for testicular cancer. Int J Mol Epidemiol Genet 2014; 5:135-139. [PMID: 25379132 PMCID: PMC4214260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/10/2014] [Indexed: 06/04/2023]
Abstract
Despite the notion that monozygotic (identical) twins share 100% identical genetic information, genetic differences among monozygotic twin pairs do occur and can be explained by mechanisms occurring during post-zygotic events. Despite such twins being fundamentally "identical", these post-zygotic genetic changes may give rise to phenotypic differences and genetic diseases. Consequently, studies of monozygotic twin pairs discordant for specific genetic diseases represent an important tool for the identification of disease genes. We used array comparative genomic hybridization (aCGH) and methylation arrays to search for genetic and epigenetic differences in blood drawn from four monozygotic twin pairs discordant for testicular germ cell tumors. No consistent differences were identified. A larger twin study would be required to achieve confident discovery of very subtle differences between monozygotic twins discordant for testicular germ cell tumors.
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Affiliation(s)
- Christian P Kratz
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesRockville, Maryland, USA
- Department of Pediatric Hematology/Oncology, Hannover Medical SchoolHannover, Germany
| | - Daniel C Edelman
- Genetics Branch, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesBethesda, MD, USA
| | - Yonghong Wang
- Genetics Branch, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesBethesda, MD, USA
| | - Paul S Meltzer
- Genetics Branch, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesBethesda, MD, USA
| | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human ServicesRockville, Maryland, USA
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Abstract
Sperm have a vital role in the continuity of a species by contributing genetic information to the next generation. Production of these specialized gametes in numbers sufficient to confer normal fertility occurs via cycling of the spermatogenic lineage, a process referred to as spermatogenesis. Continuity relies on the activities of a self-renewing reservoir of spermatogonial stem cells (SSCs) from which progenitors will arise that transiently amplify in number before committing to a pathway of terminal differentiation. A primary population of SSCs is established during neonatal development from a pool of quiescent gonocyte precursors that forms in embryogenesis. Disruption of this process has dire consequences on maintenance of a cycling spermatogenic lineage in adulthood. At present, the molecular mechanisms underlying initial formation of the SSC pool are largely undefined. However, several transcription factors and posttranscriptional regulators have been identified as important regulators of SSC self-renewal from studies with mutant mouse models and experimental manipulation within primary cultures of mouse SSCs. Importantly, loss of function of these self-renewal factors may be underlying causes of infertility. Furthermore, disruption in the establishment of the SSC state within gonocytes or misregulation of self-renewal may manifest as testicular germ cell tumors in postnatal life.
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Affiliation(s)
- Qi-En Yang
- Center for Reproductive Biology, School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Jon M Oatley
- Center for Reproductive Biology, School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA.
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