Stem cell factor as a novel diagnostic marker for early malignant germ cells
Carcinoma in situ (CIS) of the testis is the pre-invasive stage of type II testicular germ cell tumours (TGCTs) of adolescents and adults. These tumours are the most frequently diagnosed cancer in Caucasian adolescents and young adults. In dysgenetic gonads, the precursor of type II GCTs can be either CIS or a lesion known as gonadoblastoma (GB). CIS/GB originates from a primordial germ cell (PGC)/gonocyte, ie an embryonic cell. CIS can be cured by local low-dose irradiation, with limited side effects on hormonal function. Therefore, strategies for early diagnosis of CIS are essential. Various markers are informative to diagnose CIS in adult testis by immunohistochemistry, including c-KIT, PLAP, AP-2γ, NANOG, and POU5F1 (OCT3/4). OCT3/4 is the most informative and consistent in presence and expression level, resulting in intense nuclear staining. In the case of maturational delay of germ cells, frequently present in gonads of individuals at risk for type II (T)GCTs, use of these markers can result in overdiagnosis of malignant germ cells. This demonstrates the need for a more specific diagnostic marker to distinguish malignant germ cells from germ cells showing maturation delay. Here we report the novel finding that immunohistochemical detection of stem cell factor (SCF), the c-KIT ligand, is informative in this context. This was demonstrated in over 400 cases of normal (fetal, neonatal, infantile, and adult) and pathological gonads, as well as TGCT-derived cell lines, specifically in cases of CIS and GB. Both membrane-bound and soluble SCF were expressed, suggestive of an autocrine loop. SCF immunohistochemistry can be a valuable diagnostic tool, in addition to OCT3/4, to screen for precursor lesions of TGCTs, especially in patients with germ cell maturation delay.
|Keywords||Adolescent, Adult, Biological, Carcinoma in Situ, Carcinoma in situ, Diagnostic marker, Gonadoblastoma, Humans, Immunohistochemistry, Infant, Male, Maturational delay, OCT3/4, Pathogenesis, Primordial germ cells, Reverse Transcriptase Polymerase Chain Reaction, Stem Cell Factor, Stem cell factor, Testicular Neoplasms, Tumor Markers, Type II (testicular) germ cell tumours, article, autocrine effect, cancer diagnosis, carcinoma in situ, cell maturation, controlled study, diagnostic value, early cancer, germ cell tumor, gonadoblastoma, human, human cell, human tissue, immunohistochemistry, male, membrane binding, octamer transcription factor 4, pathology, priority journal, protein expression, stem cell factor, tumor marker|
|Persistent URL||dx.doi.org/10.1002/path.2378, hdl.handle.net/1765/15949|
Stoop, J.A., Honecker, F.U., van de Geijn, G.J.M., Gillis, A.J., Cools, M.B.C.M., de Boer, M., … Looijenga, L.H.J.. (2008). Stem cell factor as a novel diagnostic marker for early malignant germ cells. Journal of Pathology, 216(1), 43–54. doi:10.1002/path.2378