Giwercman A, Hopman A H, Ramaekers F C, Skakkebaek N E
University Department of Obstetrics and Gynaecology, Rigshospitalet, Copenhagen, Denmark.
Am J Pathol. 1990 Mar;136(3):497-502.
Testicular germ cell tumors can be prevented if the neoplasia is diagnosed at the stage of carcinoma in situ (CIS). Hyperdiploid DNA content is one of the markers of CIS germ cells. We developed a noninvasive procedure for detection of CIS of the testis by means of a nonradioactive in situ hybridization assay with a probe for chromosome 1. Seminal cytospin smears from 2 men with isolated CIS changes, from 6 men in whom CIS was combined with a tumor, and from 16 control men without evidence of testicular neoplasia were tested. Ejaculates from men with CIS contained on average 2.6% hyperdiploid cells, whereas the corresponding percentage in the smears from controls was 0.2 (P = 0.009). In a blind study we identified samples from both patients with isolated CIS changes and from 3 of the 6 men in whom CIS was accompanied by a tumor, based on the percentage of the hyperdiploid cells. No false-positive results were obtained. Thus this study confirmed findings of previous immunocytochemical and flow cytometric studies that indicated exfoliation of CIS germ cells into seminal fluid. For detection of aneuploid cells in semen, in situ hybridization may be a more sensitive technique than flow cytometry. Applied on seminal samples, in situ hybridization may become a valuable and fast tool for diagnosis of CIS and thereby for prevention of testicular cancer.
如果在原位癌（CIS）阶段诊断出肿瘤形成，睾丸生殖细胞肿瘤是可以预防的。超二倍体DNA含量是CIS生殖细胞的标志物之一。我们开发了一种非侵入性程序，通过使用针对1号染色体的探针进行非放射性原位杂交测定来检测睾丸CIS。对2名患有孤立CIS变化的男性、6名CIS合并肿瘤的男性以及16名无睾丸肿瘤证据的对照男性的精液细胞涂片进行了检测。患有CIS的男性射精中平均含有2.6%的超二倍体细胞，而对照组涂片的相应百分比为0.2（P = 0.009）。在一项盲法研究中，我们根据超二倍体细胞的百分比，从患有孤立CIS变化的患者以及6名CIS伴有肿瘤的男性中的3名男性中识别出了样本。未获得假阳性结果。因此，本研究证实了先前免疫细胞化学和流式细胞术研究的结果，即CIS生殖细胞会脱落到精液中。对于检测精液中的非整倍体细胞，原位杂交可能是比流式细胞术更敏感的技术。应用于精液样本时，原位杂交可能成为诊断CIS从而预防睾丸癌的一种有价值且快速的工具。
