Document Detail

Risk of germ cell malignancy in children with XY intersex versus isolated cryptorchidism by immunohistochemistry.
MedLine Citation:
PMID:  16908459     Owner:  NLM     Status:  MEDLINE    
The risk of subsequent development of testicular germ cell neoplasia is related to presence of underlying developmental defects such as cryptorchidism, in which the risk is around 0.5%, and XY intersex with abdominal testes, in which the risk may be as high as 20-25%. We examined the hypothesis that the increased risk of germ cell malignancy in intersex testes with Y chromosome was a direct consequence of an abnormal increase in number of PLAP/CD117+ immature germ cells into postnatal life. Archival cases of uncomplicated cryptorchidism (CO) and XY intersex (INT) were identified and anonymized, and a subgroup of aged-matched cases had sections immunostained with placental alkaline phosphatase (PLAP) and CD117. From a total of 89 intersex and 105 cryptorchid cases identified, a power calculation to detect a 20% difference in expression between groups (alpha = 0.05, power = 80%) determined that 18 intersex and 36 cryptorchid cases were required. Thus, 58 cases were examined, median age 3 (range birth-11) years, including 39 CO and 19 INT. The prevalence of any PLAP+ germ cells was 2/39 (5.1%) versus 3/19 (15.7%), respectively. (Z = 1.4, p = 0.17). In contrast, 94% of cases showed presence of any CD117+ germ cells, but the frequency of CD117+ cells was not significantly different between groups (t = 0.56, p = 0.58). CD117 and PLAP identify different populations of germ cells in pediatric testes. The extent of increased risk of malignancy in XY INT is not simply related to increased numbers of immature PLAP+/CD117+ germ cells present; additional factors play a pathogenic role.
H Law; I Mushtaq; S Williams; M Malone; N J Sebire
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Fetal and pediatric pathology     Volume:  25     ISSN:  1551-3815     ISO Abbreviation:  Fetal Pediatr Pathol     Publication Date:    2006 Mar-Apr
Date Detail:
Created Date:  2006-08-15     Completed Date:  2006-09-26     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  101230972     Medline TA:  Fetal Pediatr Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  95-105     Citation Subset:  IM    
Department of Pediatric Pathology, Great Ormond Street Hospital, London, UK.
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MeSH Terms
Alkaline Phosphatase / metabolism
Child, Preschool
Chromosomes, Human, X*
Chromosomes, Human, Y*
Cryptorchidism / epidemiology,  metabolism,  pathology*
Databases, Factual
Germinoma / epidemiology,  metabolism,  pathology*
Hermaphroditism / epidemiology,  metabolism,  pathology*
Immunohistochemistry / methods
Infant, Newborn
Proto-Oncogene Proteins c-kit / metabolism
Testicular Neoplasms / epidemiology,  metabolism,  pathology*
Testis / metabolism,  pathology
Tumor Markers, Biological / metabolism
Reg. No./Substance:
0/Tumor Markers, Biological; EC Proteins c-kit; EC Phosphatase

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