Usefulness of Contralateral Biopsy with Oct3 or 4 and Plap Marker Assessment to Detect Germ Cell Neoplasia In situ In Patients With Testicular Cancer - Abstract
Background: The most common type of testicular cancer (TC) is the germ cell tumor, which occurs disproportionately in young men. Although most patients with TC undergo unilateral orchiectomy, contralateral testicular biopsy is still not routinely performed. A predictor of this tumor is germ cell neoplasia in situ (GCNIS), which can be detected by histological evaluation or immunohistochemistry (IHC) of the biopsy specimen. Because treatment varies by neoplasm type, early detection is important in patients with TC.
Materials and methods: A retrospective study was conducted to identify patients with TC who received contralateral biopsy during orchiectomy at our hospital from 2005 to 2016. All specimens were histologically evaluated by morphological characteristics to diagnose GCNIS. In 2011, biopsies were assessed with IHC for two immunomarkers, octamer-binding transcription factor 3/4 (OCT3/4) and placental alkaline phosphatase (PLAP), to detect GCNIS.
Results: In total, 233 patients with TC underwent contralateral biopsy at our hospital from 2005 to 2016. The routine use of immunohistochemistry for OCT3/4 and PLAP significantly improved the detection of GCNIS. Before 2011, GCNIS was diagnosed in 2% of cases. However, during 2011–2016, the routine use of OCT3/4 and PLAP markers detected GCNIS in 5.5% of cases.
Conclusion: The routine use of contralateral biopsies with IHC for OCT3/4 and PLAP improved the detection rate of GCNIS in patients with TC. Although routine contralateral biopsy with IHC is still controversial in some countries, we found the procedure to be effective for increasing early detection rates and improving the patient outcomes.