The Department of Pediatric Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
The Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Pediatr Surg Int. 2020 Oct;36(10):1249-1254. doi: 10.1007/s00383-020-04725-w. Epub 2020 Aug 9.
Positive staining of testicular germ cells for PLAP and c-Kit beyond infancy may be associated with the presence of GCNIS (Germ Cell Neoplasia In Situ). We recently reported our findings of positive staining of normal, infantile germ cells for PLAP, and c-Kit up to 2 years of age, contrary to previous studies. The present study aims to elucidate whether otherwise normal testes of boys undergoing puberty express PLAP, c-Kit, Oct3/4, or D2-40.
Biopsies were taken from 31 boys (11.5-16.5 years of age, mean and median of 13.5 years), who underwent surgery either for torsion of the testis (15) or a history suspicious of intermittent torsion of the testis (16). 21 were biopsied on both sides, making a total of 52 biopsies. Four testes were necrotic. The biopsies were fixed in Stieve's medium, cut into 2 μm sections, and mounted on coated slides. One slide was processed for H-E, and the others incubated with primary antibody for PLAP, c-Kit, D2-40, and Oct3/4.
87% of the boys stained positive for both PLAP and c-Kit. None were positive for either D2-40 or Oct3/4. None had any histological features characteristic of GCNIS. Only two boys showed no signs of having initiated spermatogenesis. Those positive for PLAP were likewise for c-Kit, and vice versa, except 2; one boy, 13 years, was positive for PLAP, but negative for c-KIT, another, 16 years, was negative for PLAP and positive for c-Kit. Three boys stained positive for PLAP and c-Kit on the right side, and negative on the left. One boy was negative for c-Kit on the right side, positive on the left, and positive for PLAP bilaterally.
Positive staining of testicular germ cells for PLAP and c-Kit seems to be a normal finding in boys not having completed puberty. Rather than indicating pre-malignant transformation, the positivity is indicative of an ongoing maturational process of the germ cells.
在婴儿期之后，睾丸生殖细胞对 PLAP 和 c-Kit 的阳性染色可能与 GCNIS（生殖细胞肿瘤原位）的存在有关。我们最近报告了我们的发现，即正常的婴儿期生殖细胞在 2 岁之前对 PLAP 和 c-Kit 的阳性染色，这与之前的研究结果相反。本研究旨在阐明正在经历青春期的男孩的正常睾丸是否表达 PLAP、c-Kit、Oct3/4 或 D2-40。
对 31 名男孩（11.5-16.5 岁，平均年龄和中位数为 13.5 岁）进行了手术活检，这些男孩因睾丸扭转（15 例）或睾丸间歇性扭转病史可疑（16 例）而接受手术。其中 15 例双侧睾丸均进行了活检，共进行了 52 例活检。4 例睾丸坏死。活检标本用 Stieve 介质固定，切成 2μm 切片，贴在涂覆的载玻片上。一张载玻片用于 H-E 处理，其余载玻片用 PLAP、c-Kit、D2-40 和 Oct3/4 的一抗孵育。
87%的男孩 PLAP 和 c-Kit 均呈阳性。没有一个 D2-40 或 Oct3/4 阳性。没有一个具有 GCNIS 的特征性组织学特征。只有 2 名男孩没有任何开始精子发生的迹象。PLAP 阳性的男孩同样 c-Kit 阳性，反之亦然，除了 2 例；一名 13 岁的男孩 PLAP 阳性，c-KIT 阴性，另一名 16 岁的男孩 PLAP 阴性，c-Kit 阳性。3 名男孩右侧 PLAP 和 c-Kit 阳性，左侧阴性。一名男孩右侧 c-Kit 阴性，左侧阳性，双侧 PLAP 阳性。
PLAP 和 c-Kit 阳性的睾丸生殖细胞似乎是未完成青春期的男孩的正常发现。阳性染色不是恶性转化的前兆，而是生殖细胞成熟过程的指示。
