Fertility & Hormone Preservation & Restoration Program, Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Fertility & Hormone Preservation & Restoration Program, Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
J Pediatr Surg. 2024 Nov;59(11):161632. doi: 10.1016/j.jpedsurg.2024.07.017. Epub 2024 Jul 18.
For all fertility preservation (FP) cases at our institution, a biopsy is performed for routine pathology from all gonadal tissue removed. This is not standard at all centers. We reviewed our experience with biopsy for pathological evaluation of ovarian and testicular specimens in FP cases to determine clinical utility.
The medical records of individuals who underwent ovarian tissue cryopreservation (OTC) or testicular tissue cryopreservation (TTC) between 2011 and 2023 were retrospectively reviewed under an IRB-approved study at a free-standing tertiary care children's hospital. Patient demographics, diagnosis, operative characteristics, and pathology results were collected.
One-hundred and eighty-three patients underwent OTC, and 134 patients underwent TTC. All patients had their gonadal tissue biopsied for routine pathology. Malignancy was identified in the biopsies of 4 OTC patients (2.2%) and 2 TTC patients (1.5%). Two OTC patients (1.1%) and 2 TTC patients (1.5%) did not have germ cells identified in their biopsy. All OTC and TTC patients and families elected to continue storing tissue for FP after discussion of pathology findings.
Pathology results provide another data point to help inform patients and their families when making decisions on ovarian or testicular tissue storage and on how tissue may be utilized in the future to restore fertility and/or hormones. There is a low rate of identifying malignancy in gonadal tissue biopsies taken from FP specimens even in patients with known malignancy. However, when malignancy was identified, it could be unexpected and alter the diagnosis and treatment plan significantly for patients.
IV.
在我们机构的所有生育力保存（FP）病例中，都会对切除的所有性腺组织进行常规病理活检。这并非所有中心的标准做法。我们回顾了 FP 病例中卵巢和睾丸标本的活检进行病理评估的经验，以确定其临床效用。
在一家独立的三级儿童保健医院进行的一项 IRB 批准的研究中，回顾性分析了 2011 年至 2023 年间接受卵巢组织冷冻保存（OTC）或睾丸组织冷冻保存（TTC）的个体的医疗记录。收集了患者的人口统计学、诊断、手术特征和病理结果。
183 名患者接受了 OTC，134 名患者接受了 TTC。所有患者的性腺组织均进行了常规病理活检。在 4 名 OTC 患者（2.2%）和 2 名 TTC 患者（1.5%）的活检中发现了恶性肿瘤。2 名 OTC 患者（1.1%）和 2 名 TTC 患者（1.5%）的活检中未发现生殖细胞。所有 OTC 和 TTC 患者及其家属在讨论了病理结果后，均选择继续储存组织以进行 FP。
病理结果提供了另一个数据点，可以帮助患者及其家属在决定是否储存卵巢或睾丸组织以及将来如何利用组织来恢复生育力和/或激素方面做出决策。即使在已知患有恶性肿瘤的患者中，从 FP 标本中获取的性腺组织活检中恶性肿瘤的检出率也很低。然而，当发现恶性肿瘤时，它可能是意外的，并显著改变患者的诊断和治疗计划。
IV。
