Balcı Mahi, Aydemir Akkaya Merva
Kırıkkale University, Kırıkkale, Turkey.
Van Yüzüncü Yıl University, Van, Turkey.
Clin Med Insights Oncol. 2025 Jun 16;19:11795549251347339. doi: 10.1177/11795549251347339. eCollection 2025.
The incidence of testicular tumors during the COVID-19 pandemic has raised questions about the potential impact of viral infection on tumor development. This study aimed to explore the relationship between COVID-19 and testicular tumors through a retrospective analysis of 32 cases diagnosed before and during the pandemic.
A total of 32 testicular tumors were analyzed, with distribution based on the year of diagnosis. Immunohistochemical studies were conducted to assess SARS-CoV-2 and angiotensin-converting enzyme 2 (ACE2) expression in tumor cells.
The highest frequency of tumor diagnoses was observed in 2021 (19.4%), with a notable increase in diagnoses in 2022 compared with pre-pandemic years. No significant correlation was found between COVID-19 infection and tumor types ( = .476). The distribution of seminoma and mixed germ cell tumors (MGCT) was similar in both periods. Strong SARS-CoV-2 antibody positivity was found in 11 cases, with expression primarily in Leydig cells and some in Sertoli and plasma cells. The difference in SARS-CoV-2 expression between periods was statistically significant ( = 0013). The ACE2 expression was observed in all tumor groups, but statistical analysis was not significant.
The presence of SARS-CoV-2 nucleoprotein in the tumor microenvironment, particularly during the pandemic, suggests an indirect role of the virus in the development of testicular tumors. Although SARS-CoV-2 does not exhibit direct oncogenic effects, its presence could influence tumorigenesis through mechanisms like inflammation and oxidative stress. The ACE2 expression further supports the hypothesis that the virus may trigger adaptive changes in tumor cells. The SARS-CoV-2 could act as a co-factor in tumor progression, especially in individuals predisposed to testicular tumors.
新冠疫情期间睾丸肿瘤的发病率引发了关于病毒感染对肿瘤发展潜在影响的疑问。本研究旨在通过对疫情前及疫情期间诊断的32例病例进行回顾性分析，探讨新冠病毒与睾丸肿瘤之间的关系。
共分析了32例睾丸肿瘤，根据诊断年份进行分布。进行免疫组织化学研究以评估肿瘤细胞中严重急性呼吸综合征冠状病毒2（SARS-CoV-2）和血管紧张素转换酶2（ACE2）的表达。
2021年观察到肿瘤诊断的频率最高（19.4%），与疫情前年份相比，2022年的诊断有显著增加。未发现新冠病毒感染与肿瘤类型之间存在显著相关性（P = 0.476）。两个时期精原细胞瘤和混合性生殖细胞肿瘤（MGCT）的分布相似。在11例病例中发现了强烈的SARS-CoV-2抗体阳性，表达主要在睾丸间质细胞，部分在支持细胞和浆细胞中。不同时期SARS-CoV-2表达的差异具有统计学意义（P = 0.0013）。在所有肿瘤组中均观察到ACE2表达，但统计分析无显著性差异。
肿瘤微环境中存在SARS-CoV-2核蛋白，特别是在疫情期间，提示该病毒在睾丸肿瘤发展中起间接作用。虽然SARS-CoV-2不表现出直接的致癌作用，但其存在可能通过炎症和氧化应激等机制影响肿瘤发生。ACE2表达进一步支持了病毒可能触发肿瘤细胞适应性变化的假说。SARS-CoV-2可能作为肿瘤进展的辅助因子，尤其是在易患睾丸肿瘤的个体中。
