Germ Cell Cancer

Researchers at Memorial Sloan Kettering Cancer Center, Department of Pathology have published new data on embryonal carcinoma immunology

"A total of 50 mixed testicular germ cell tumors, 43 also containing difficult-to-classify areas, were studied. In these areas, multiple morphological parameters were noted, and high-grade nuclear details similar to typical embryonal carcinoma were considered 'embryonal carcinoma-like high-grade'. Immunohistochemical staining for OCT3/4, c-kit, CD30, SOX2, and GDF3 was performed and graded in each component as 0, negative; 1+, 1-25%; 2+, 26-50%; and 3+, >50% positive staining cells. The different components identified in these tumors were seminoma (8), embryonal carcinoma (50), yolk sac tumor (40), teratoma (40), choriocarcinoma (3) and intra-tubular germ cell neoplasia, unclassified (35). By immunohistochemistry, the staining patterns were OCT3/4 -3+, all seminomas, embryonal carcinomas and intra-tubular germ cell neoplasia; SOX2 -3+, all embryonal carcinomas and -2 to 3+, 11/14 (79%) primitive neuroectodermal components in immature teratomas; GDF3 -2 to 3+, all yolk sac tumors, seminomas and intra-tubular germ cell neoplasia and 1 to 2+, 40/50 embryonal carcinomas. A total of 34/43 (79%) of difficult-to-classify areas stained 3+ for OCT3/4, CD30, and SOX2, similar to embryonal carcinoma. Among these areas, only 'embryonal carcinoma-like high-grade' nuclear details were significantly associated with such an immunophenotype. Thus, SOX2 is expressed in embryonal carcinoma and primitive neuroectoderm of teratoma, and unlike OCT3/4, not in intra-tubular germ cell neoplasia and seminoma. Therefore, it may be useful in the distinction of seminoma from embryonal carcinoma, and potentially in diagnosing early carcinomatous differentiation in seminoma," wrote A. Gopalan and colleagues, Memorial Sloan Kettering Cancer Center, Department of Pathology.

The researchers concluded: "GDF3 positivity, in the absence of OCT3/4 and CD30, combined with morphological features, is helpful in the diagnosis of yolk sac tumor. 'Embryonal carcinoma-like high-grade' nuclear details are the most important morphological criterion for the diagnosis of embryonal carcinoma in difficult-to-classify areas."

Gopalan and colleagues published their study in Modern Pathology (Testicular mixed germ cell tumors: a morphological and immunohistochemical study using stem cell markers, OCT3/4, SOX2 and GDF3, with emphasis on morphologically difficult-to-classify areas. Modern Pathology, 2009;22(8):1066-74).

For additional information, contact A. Gopalan, Memorial Sloan Kettering Cancer Center, Dept. of Pathology, New York City, NY 10065 USA..

The publisher of the journal Modern Pathology can be contacted at: Nature Publishing Group, 345 Park Avenue South, New York, NY 10010-1707, USA.

Keywords: United States, New York, Embryonal Carcinoma Immunology, Chorio Cancer, Chorio Carcinoma, Differential Diagnosis, Embryonal Cancer, Germ Cell Cancer, Germ Cell Carcinoma, Immunology, Neoplasia, Oncology, P19 Embryonal Carcinoma, Pathology, Seminoma, Stem Cell Research, Teratoma, Urology.

This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2009, Clinical Oncology Week via NewsRx.com.