Verdi C J, Hutter J, Grogan T M
Department of Pathology, University of Arizona School of Medicine, Tucson 85724.
Pediatr Pathol. 1989;9(2):117-30. doi: 10.3109/15513818909022340.
This study establishes the utility of immunophenotyping testicular biopsy specimens in patients with acute lymphoid leukemia. The value of immunophenotyping in detecting or excluding leukemic testicular infiltration is demonstrated in six children with acute lymphocytic leukemia. A panel of monoclonal antibodies was employed on snap-frozen testicular biopsies, allowing both detection and immunologic characterization of four neoplastic lymphocytic infiltrates. Two samples were proven both histologically and phenotypically negative for leukemic infiltration. One of the four leukemic cases was clinically silent and might have escaped detection except for phenotyping. One leukemic infiltrate was also suspected to possess a multidrug-resistant phenotype (p-glycoprotein +); the latter possibility was excluded by an absence of reactivity with anti-p-glycoprotein monoclonal antibody. Thus, three clinically useful applications are demonstrated: (1) confirmation of testicular leukemic relapse, gaining assertion in histologically uncertain cases; (2) exclusion of clinically suspected disease relevant to cessation of therapy, and (3) detection/exclusion of drug-resistant phenotypes. Unexpectedly, we found expression of plasma cell-associated antigen in testicular germ cells, which may prove to be diagnostically useful in the future evaluation of germ cell tumors.
本研究证实了免疫表型分析在急性淋巴细胞白血病患者睾丸活检标本中的应用价值。对6例急性淋巴细胞白血病患儿进行免疫表型分析，以检测或排除白血病睾丸浸润。采用一组单克隆抗体对快速冷冻的睾丸活检标本进行检测，对4例肿瘤性淋巴细胞浸润进行了检测和免疫特征分析。2份样本经组织学和表型分析均证实无白血病浸润。4例白血病病例中有1例临床上未表现出症状，若不进行表型分析可能无法被发现。1例白血病浸润还疑似具有多药耐药表型（P-糖蛋白阳性），但与抗P-糖蛋白单克隆抗体无反应，排除了后一种可能性。因此，本研究展示了免疫表型分析在临床上的三个应用：（1）确诊睾丸白血病复发，在组织学诊断不明确的病例中具有诊断意义；（2）排除因治疗终止而临床上疑似的疾病；（3）检测/排除耐药表型。意外的是，我们发现睾丸生殖细胞中表达浆细胞相关抗原，这可能在未来生殖细胞肿瘤的评估中具有诊断价值。
