el-Naggar A K, Ro J Y, McLemore D, Ayala A G, Batsakis J G
Department of Pathology, University of Texas, Houston 77030.
Am J Surg Pathol. 1992 Jun;16(6):611-8. doi: 10.1097/00000478-199206000-00009.
Flow cytometry was used to determine the DNA ploidy pattern of 148 testicular germ cell neoplasms (seminomas and nonseminomas in pure and mixed histologic phenotypes) and in situ carcinoma (CIS) adjacent to these tumors. The great majority (96.0%) manifested aneuploid DNA contents with minimal intratumoral heterogeneity (2.5%). The mean DNA indices (DI) of CIS (1.7 +/- 0.18), pure seminoma (1.82 +/- 0.55), and the seminoma component of mixed germ cell neoplasms (1.76 +/- 0.13) were statistically similar. The mean DI of nonseminomas pure (1.46 +/- 0.29) or as a component of mixed tumors (1.43 +/- 0.32) was significantly lower (p greater than 0.001) than those of CIS and seminomas. Our data suggest that the similarity between the DNA indices of CIS and seminomas provide evidence that both lesions constitute a temporal evolutionary step in the progression of germ cell tumors and that nonseminomas may subsequently arise from either CIS or seminoma by further loss of chromosomal DNA. These characteristic findings support the nonstochastic theory for germ cell evolution and progression and may be useful in the clinicopathologic evaluation of testicular masses.
采用流式细胞术测定148例睾丸生殖细胞肿瘤（包括纯组织学表型和混合组织学表型的精原细胞瘤和非精原细胞瘤）以及这些肿瘤旁原位癌（CIS）的DNA倍体模式。绝大多数（96.0%）表现为非整倍体DNA含量，肿瘤内异质性极小（2.5%）。CIS（1.7±0.18）、纯精原细胞瘤（1.82±0.55）以及混合性生殖细胞肿瘤的精原细胞瘤成分（1.76±0.13）的平均DNA指数（DI）在统计学上相似。纯非精原细胞瘤（1.46±0.29）或作为混合性肿瘤成分（1.43±0.32）的平均DI显著低于CIS和精原细胞瘤（p＞0.001）。我们的数据表明，CIS和精原细胞瘤的DNA指数相似，这证明这两种病变均构成生殖细胞肿瘤进展中的一个时间进化阶段，并且非精原细胞瘤可能随后通过进一步丢失染色体DNA而从CIS或精原细胞瘤发生。这些特征性发现支持生殖细胞进化和进展的非随机理论，可能有助于睾丸肿块的临床病理评估。
