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首页> 外文期刊>BJU international >alpha-Catenin expression pattern and DNA image-analysis cytometry have no additional value over primary histology in clinical stage I nonseminomatous testicular cancer.
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alpha-Catenin expression pattern and DNA image-analysis cytometry have no additional value over primary histology in clinical stage I nonseminomatous testicular cancer.

机译：在临床Ⅰ期非精原细胞性睾丸癌中，α-连环蛋白的表达模式和DNA图像分析细胞术没有比原发组织学更高的价值。

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摘要

OBJECTIVE: To determine whether the alpha-catenin expression pattern and DNA content have additional value over primary tumour histology, including information on vascular invasion and tunica albuginea invasion, in detecting occult metastasis in patients with clinical stage I nonseminomatous germ cell tumours of the testis (NSGCT). PATIENTS AND METHODS: Fifty consecutive patients with clinical stage I NSGCT underwent retroperitoneal lymphadenectomy (RPLND) between 1986 and 1992. The orchidectomy specimens were histopathologically reviewed and immunohistochemically stained with mouse monoclonal anti-alpha-catenin antibody. The presence of an aberrant or negative staining in >10% of the malignant cells was defined as abnormal; in all other cases tumours were classified as normal. Furthermore, intact nuclei were isolated from 50 microm thick paraffin sections of the primary tumour, Feulgen stained, and analysed with an image-analysis system. RESULTS: Of the 50 patients, 14 had positive retroperitoneal nodes (stage IIa, 28%), one pathologically staged I patient developed a lung metastasis (stage IV) within 3 months of RPLND. Univariate analysis showed that the presence of embryonal cell carcinoma, vascular invasion and tunica albuginea invasion were predictive for occult metastases. In multivariate logistic regression analysis only vascular and tunica albuginea invasion were significant. All 11 patients with no embryonal cell carcinoma in the primary tumour were classified as having pathological stage I disease. Also, the tumours which were DNA-diploid (three) or DNA-polyploid (two) were pathologically stage I. In screening for occult metastases the DNA content and the alpha-catenin expression pattern had no additional value. CONCLUSION: Vascular and tunica albuginea invasion have prognostic value in identifying patients with clinical stage I NSGCT at high risk for occult retroperitoneal disease. In contrast, the absence of embryonal cell carcinoma could predict all patients at low risk for metastasis. The DNA-ploidy also identified patients at low risk. Other DNA-analyses and the alpha-catenin expression pattern provided no additional information. Further studies are recommended to identify patients who are at low or high risk for metastasis.
机译：目的：确定α-catenin表达模式和DNA含量是否比原发性肿瘤组织学（包括有关血管浸润和白膜浸润的信息）在检测临床I期睾丸非精原性生殖细胞肿瘤患者的隐匿性转移方面具有额外价值（ NSGCT）。患者与方法：1986年至1992年间，连续对50例临床I期NSGCT患者进行了腹膜后淋巴结清扫术（RPLND）。对兰花切除术的标本进行了组织病理学检查，并用小鼠单克隆抗α-catenin抗体进行了免疫组织化学染色。大于10％的恶性细胞出现异常染色或阴性染色被定义为异常;在所有其他情况下，肿瘤被分类为正常。此外，从原发肿瘤的50微米厚的石蜡切片中分离出完整的细胞核，进行Feulgen染色，并用图像分析系统进行分析。结果：在这50例患者中，有14例腹膜后淋巴结阳性（IIa期，28％），其中一名病理分期为I的患者在RPLND后3个月内发生了肺转移（IV期）。单因素分析表明，胚胎细胞癌，血管浸润和白膜浸润的存在是隐匿性转移的预兆。在多元逻辑回归分析中，仅血管和白膜的浸润是显着的。原发性肿瘤中无胚胎细胞癌的所有11例患者均被分类为病理I期疾病。同样，DNA二倍体（三个）或DNA多倍体（两个）的肿瘤在病理上处于I期。在隐匿性转移筛查中，DNA含量和α-catenin表达模式没有附加价值。结论：血管和白膜的浸润在鉴别临床I期NSGCT中隐匿性腹膜后疾病的高风险患者中具有预后价值。相反，没有胚胎细胞癌可以预测所有患者的转移风险较低。 DNA倍体还鉴定出低危患者。其他DNA分析和alpha-catenin表达模式未提供其他信息。建议进行进一步的研究以鉴定低或高转移风险的患者。

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