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Hum. Reprod. Advance Access published online on January 13, 2005
Human Reproduction, doi:10.1093/humrep/deh759
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Human Reproduction © European Society of Human Reproduction and Embryology 2005; all rights reserved
Received December 2, 2004
Revised December 23, 2004
Accepted December 30, 2004

Case Report

Fast-track Article: A subfertile patient diagnosed with testicular carcinoma in situ by immunocytological staining for AP-2{gamma} in semen samples: Case report

C.E. Hoei-Hansen 1*, E. Rajpert-De Meyts 1, E. Carlsen 1, K. Almstrup 1, H. Leffers 1, and N.E. Skakkebaek 1

1 University Department of Growth and Reproduction (GR-5064), Rigshospitalet Blegdamsvej 9, DK-2100 Copenhagen, Denmark

* To whom correspondence should be addressed.
C.E. Hoei-Hansen, E-mail: chh{at}dadlnet.dk


  Abstract

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

Keywords: carcinoma in situ testis; intratubular germ cell neoplasia; testicular germ cell cancer; testicular intraepithelial neoplasia; TFAP2C.
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