Summary
Immunohistochemistry greatly contributes to the accuracy of the diagnosis in testicular germ cell tumors (TGCT). Human chorionic gonadotropin (HCG) and alphafetoprotein (AFP) are the most used markers in testicular cancer, where the immunostaining is positive in non-seminomatous TGCT. Pure seminoma does not produce these proteins but some are combined with syncytiotrophoblastic cells which elaborate HCG, producing elevated HCG serum levels and positive immunostaining. Other markers deserve mention. Among these there are placental alkaline phosphatase (PLAP), ferritin (Fe), pregnancy specific beta1-glycoprotein (SP1), human placental lactogen (HPL), carcinoembrionic antigen (CEA) and alpha1-antitrypsin (A1AT). In addition, the recognition of intermediate filament proteins, such as keratin and vimentin, allow differentiation between seminoma and embryonal carcinoma.
Similar content being viewed by others
References
Battifora H, Sheibani K, Tubbs RR, Kopinski MI, Sun TT (1984) Antikeratin antibodies in tumor diagnosis. Distinction between seminoma and embryonal carcinoma. Cancer 54:843–848
Beckstead JH (1983) Alkaline phosphatase histochemistry in human germ cell neoplasms. Am J Surg Pathol 7:341–349
Beilby JOW, Horne CHW, Milne GD, Parkinson C (1979) Alphafetoprotein, alpha1-antitrypsin, and transferrin in gonadal yolk sac tumours. J Clin Pathol 32:455–461
Bosman FT, Giard RWM, Nieuwenhuijen Kruseman AC, Spaander PJ (1980) Human chorionic gonadotropin and alpha-fetoprotein in testicular germ cell tumours: a retrospective immunohistochemical study. Histopathology 4:673–684
Caillaud JM, Bellet D, Carlu C, Droz JP (1985) Immunohistochemistry of germ cell tumors of the testis. Study of beta HCG and AFP. Progr Clin Biol Res 203:139–140
Chisholm GD (1985) Tumor markers in testicular tumours. Progr Clin Biol Res 203:81–91
Cohen C, Shulman G, Budgeon LR (1984) Immunohistochemical ferritin in testicular seminoma. Cancer 54:2190–2194
Corson JM (1986) Keratin protein immunohistochemistry in surgical pathology practice. Ann Pathol 21:47–81
Endo Y, Urano Y, Tsuchida Y, Asaka T, Kaneko Y, Kaneko M, Sakashita S, Tsukada Y, Watabe H, Hirai H, Oda T (1978) Protein synthesis in yolk sac tumor: histochemical studies of human and rat yolk sac tumor. Scand J Immunol 8:171–180
Epenetos AA, Travers P, Gatter KC, Oliver RDT, Mason DY, Bodmer WF (1984) An immunohistological study of testicular germ cell tumours using two different monoclonal antibodies against placental alkaline phosphatase. Brit J Cancer 49:11–15
Espinoza CC, Azar HA (1982) Immunohistochemical localization of keratin-type proteins in epithelial neoplasms. Correlation with electron microscopic findings. Am J Clin Pathol 78:500–507
Fossa SD, Risberg T (1985) β-HCG producing seminoma. Progr Clin Biol Res 203:105–106
Friedman L, Pearlman AW (1970) Seminoma with trophocarcinoma. Cancer 26:46–64
Gown AM, Vogel AM (1985) Monoclonal antibodies to human intermediate filament proteins III. Analysis of tumors. Am J Clin Pathol 84:413–424
Heyderman E (1978) Multiple tissue markers in human malignant testicular tumours. Scand J Immunol 8:119–126
Heyderman E, Neville AM (1976) Syncytiotrophoblasts in malignant testicular tumours. Lancet 2:103
von Hochstetter AR, Sigg Chr, Saremaslani P, Hedinger Chr (1985) The significance of giant cells in human testicular seminomas. Virchows Arch (A) 407:309–322
Jacobsen GK (1986) Histogenetic considerations concerning germ cell tumours. Virchows Arch (A) 408:509–525
Jacobsen GK, Nøgaard-Pedersen B (1984) Placental alkaline phosphatase in testicular germ cell tumours and in carcinoma-in-situ of the testis. Acta Pathol Microbiol Immunol Scand [A] 92:323–329
Jacobsen GK, Jacobsen M, Clausen PP (1981) Distribution of tumor-associated antigens in the various histologic components of germ cell tumors of the testis. Am J Surg Pathol 5:257–266
Javadpour N (1979) Serum and cellular biologic markers in patients with urologic cancer. Human Pathol 10:557–568
Javadpour N (1983) Multiple biochemical tumor markers in seminoma. Cancer 52:887–889
Javadpour N (1986) Misconception and source of errors in interpretation of cellular and serum markers in testicular cancer. J Urol 135:879
Javadpour N, Utz M, Soares T (1980) Immunocytochemical discordance in localization of pregnancy specific beta1 glycoprotein, alpha-fetoprotein and human chorionic gonadotropin in testicular cancers. J Urol 124:615–616
Jeppsson A, Wahren B, Stigbrand T, Edsmyr F, Andersson L (1983) A clinical evaluation of serum placental alkaline phosphatase in seminoma patients. Brit J Urol 55:73–78
Kahn HJ, Yeger H, Baumal R (1983) Categorization of pediatric neoplasms by immunostaining with antiprekeratin and antivimentin antisera. Cancer 51:645–653
Kurman RJ, Scardino PT, McIntire KR, Waldmann TA, Javadpour N (1977) Cellular localization of alpha-fetoprotein and human chorionic gonadotropin in germ cell tumors of the testis using an indirect immunoperoxidase technique. Cancer 40:2136–2151
Lange PH, Millan JL, Stigbrand T, Vessella RL, Ruoslahti E, Fishman WH (1982) Placental alkaline phosphatase as a tumor marker for seminoma. Cancer Res 42:3244–3247
Maier JG, Sulak MH (1973) Radiation therapy in malignant testis tumors. Cancer 32:1217–1226
Makin CA, Bobrow LG, Bodmer WF (1984) Monoclonal antibody to cytokeratin for use in routine histopathology. J Clin Pathol 37:975–983
Miettinen M, Virtanen I, Talerman A (1985) Intermediate filament proteins in human testis and testicular germ-cell tumors. Am J Pathol 120:402–410
Mostofi FK, Sesterhenn IA (1985) Pathology of germ-cell tumors of testes. Progr Clin Biol Res 203:1–34
Pinkus GS, Etheridge CL, O'Connor EM (1986) Are keratin proteins a better tumor marker than epithelial membrane antigen? A comparative immunohistochemical study of various paraffin embedded neoplasms using monoclonal and polyclonal antibodies. Am J Clin Pathol 85:269–277
Porteus IB, Beck JS, Pugh RCB (1968) Localization of human placental factor in malignant teratoma of testis. J Pathol Bact 95:527–535
Ramaekers F, Feitz W, Moesker O, Schaart G, Herman C, Debruyne F, Vooijs P (1985) Antibodies to cytokeratin and vimentin in testicular tumours diagnosis. Virchows Arch (A) 408:127–142
Ruoslahti E, Engvall E, Pekkala A, Sepällä M (1978) Developmental changes in carbohydrate moiety of human alpha-fetoprotein. Int J Cancer 22:518–520
Scheiber K, Mikuz G, Frommhold H, Bartsch G (1985) Human chorionic gonadotropin-positive seminoma: is this a special type of seminoma with a poor prognosis? Progr Clin Biol Res 203:97–104
Seralini GE, Stora C (1986) L'alphafetoprotéine. Bull Cancer 73:320–324
Sidi AA, Chiou RK, Lange PH (1984) Recent reflexions on tumor markers. World J Urol 2:18–25
Skakkebaek NE (1975) Atypical germ cells in the adjacent “normal” tissue of testicular tumors. Acta Pathol Microbiol Scand (A) 83:127–130
Skakkebaek NE (1978) Carcinoma in situ of the testis: Frequency and relationship to invasive germ cell tumors in infertile men. Histopathology 2:157–170
Spagnolo DV, Michie SA, Crabtree GS, Warnke RA, Rouse RV (1985) Monoclonal anti-keratin (AE1) reactivity in routinely processed tissue from 166 human neoplasms. Am J Clin Pathol 84:697–704
Swartz DA, Johnson DE, Hussey DH (1984) Should an elevated human chorionic gonadotropin titer alter therapy for seminoma? J Urol 131:63–65
Thackray AC, Crane WAJ (1976) Seminoma. In: Pugh RCB (ed) Pathology of the testis. Blackwell, Oxford, pp 164–198
Uchida T, Schimoda T, Miyata H, Shikata T, Iino S, Suzuki H, Oda T, Hirano K, Sugiura M (1981) Immunoperoxidase study of alkaline phosphatase in testicular tumor. Cancer 48: 1455–1462
Wahren B, Alpert E, Esposti P (1977) Multiple antigens as marker substances in germinal tumors of the testis. J Natl Cancer Inst 58:489–498
Wahren B, Holmgren PA, Stigbrand T (1979) Placental alkaline phosphatase, alphafetoprotein, and carcinoembryonic antigen in testicular tumors. Tissue typing by means of cytologic smears. Int J Cancer 24:749–753
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
de Matteis, A., di Silverio, F. Immunological tissue markers in the diagnosis of testicular cancer. World J Urol 5, 138–142 (1987). https://doi.org/10.1007/BF00327072
Issue Date:
DOI: https://doi.org/10.1007/BF00327072