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Stang A, McMaster ML, Sesterhenn IA, Rapley E, Huddart R, Heimdal K, McGlynn KA, Oosterhuis JW, Greene MH. Histological Features of Sporadic and Familial Testicular Germ Cell Tumors Compared and Analysis of Age-Related Changes of Histology. Cancers (Basel) 2021; 13:cancers13071652. [PMID: 33916078 PMCID: PMC8037944 DOI: 10.3390/cancers13071652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Testicular germ cell tumors (TGCT) are highly heritable, and earlier studies reported a higher prevalence of certain microscopic features in familial cases compared with sporadic cases. Reasoning by analogy relative to different causal genes for different histologic subtypes of familial kidney cancer, we searched for etiologically informative histopathology associations in familial testicular germ cell cancer. We conducted a detailed, blinded pathology review of familial and sporadic TGCT cases to investigate whether we could identify differences between these two patient subsets and to study the effect of age at diagnosis on histologic features in both groups combined. Our results show no specific histologic differences between familial and sporadic TGCTs. However, we observed histologic features that varied with age at diagnosis among the two groups combined. Thus, our results suggest that there are no histological differences between familial and sporadic TGCT that might identify genetically distinct disease subsets. Abstract This study aimed to compare histological features of familial and sporadic testicular germ cell tumors (TGCTs) and surrounding parenchyma, since discriminating features might be etiologically relevant and clinically useful. The study of parenchyma was prompted by reports claiming a higher prevalence of testicular microlithiasis in familial cases. Histological features of TGCTs and surrounding parenchyma of 296 sporadic and 305 familial cases were compared. For each case, one representative hematoxylin and eosin-stained slide was available. Slides were independently scored by two expert pathologists using a semi-quantitative data abstract. Discrepancies were resolved by consensus. A logistic regression model was used to assess the ability to discriminate between sporadic and familial GCT. The histological composition of a tumor, amount of lymphocytic infiltration, amount of germ cell neoplasia in situ (GCNIS), and presence of testicular microlithiasis (TM) did not discriminate between sporadic and familial GCT (area under the curve 0.56, 95%CI 0.51–0.61). Novel observations included increasing lymphocytic infiltration and decreasing GCNIS and TM with increasing age at diagnosis. The presence of tubules with infiltrating lymphocytes was mainly associated with pure seminomas and nonseminomas with a seminoma component. Among seminomas, tubules with infiltrating lymphocytes decreased with increasing age. No discernable differences between sporadic and familial TGCTs were found. The age-related changes in the tumors and surrounding parenchyma in these groups combined are consistent with a host response building up over time predominantly affecting seminomas, the seminoma-component of nonseminomas and GCNIS. TM may gradually dissolve with age. Our hypothesis that histological differences between sporadic and familial TGCT might identify genetically distinct disease subsets was not supported.
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Affiliation(s)
- Andreas Stang
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, 45147 Essen, Germany;
- School of Public Health, Department of Epidemiology, Boston University, Boston, MA 02118, USA
| | - Mary L. McMaster
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA;
- Correspondence: ; Tel.: +1-240-276-7248
| | | | - Elizabeth Rapley
- Division of Genetics and Epidemiology, Institute for Cancer Research, London SM7 1DN, UK;
| | - Robert Huddart
- Division of Radiotherapy and Imaging, Institute for Cancer Research, London SM7 1DN, UK;
| | - Ketil Heimdal
- Department of Medical Genetics, Oslo University Hospital Rikshospitalet, 0027 Oslo, Norway;
| | - Katherine A. McGlynn
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA;
| | - Jan Wolter Oosterhuis
- Department of Pathology, Josephine Nefkens Institute, Erasmus University Medical Center, 3000 DR Rotterdam, The Netherlands;
| | - Mark H. Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA;
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Yu CJ, Lu JD, Zhao J, Wei Y, Zhao TX, Lin T, He DW, Wu SD, Wei GH. Incidence characteristics of testicular microlithiasis and its association with risk of primary testicular tumors in children: a systematic review and meta-analysis. World J Pediatr 2020; 16:585-597. [PMID: 31853884 DOI: 10.1007/s12519-019-00328-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/28/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND To systematically evaluate the incidence characteristics of testicular microlithiasis (TM) in children and its association with primary testicular tumors (PTT). METHODS A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. A priori protocol was registered in the PROSPERO database (CRD42018111119), and a literature search of all relevant studies published until February 2019 was performed. Prospective, retrospective cohort, or cross-sectional studies containing ultrasonography (US) data on the incidence of TM or the association between TM and PTT were eligible for inclusion. RESULTS Of the 102 identified articles, 18 studies involving 58,195 children were included in the final analysis. The overall incidence of TM in children with additional risk factors for PTT was 2.7%. In children, the proportion of left TM in unilateral cases was 55.7%, the frequency of bilateral TM was 69.0%, and proportion of classic TM was 71.8% [95% confidence interval (CI) 62.4-81.1%, P = 0.0, I2 = 0.0%]. About 93.5% of TM remained unchanged, and newly detected PTT rate was very low (4/296) during follow-up. The overall risk ratio of TM in children with a concurrent diagnosis of PTT was 15.46 (95% CI 6.93-34.47, P < 0.00001). CONCLUSIONS The incidence of TM in children is highly variable. Nonetheless, TM is usually bilateral, of the classic type, and remains stable or unchanged at follow-up. Pediatric patients with TM and contributing factors for PTT have an increased risk for PTT; however, there is no evidence to support mandatory US surveillance of children with TM.
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Affiliation(s)
- Cheng-Jun Yu
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Jian-Dong Lu
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Jie Zhao
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Yi Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics Chongqing, Room 806, Kejiao Building (No. 6), No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, China
| | - Tian-Xin Zhao
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics Chongqing, Room 806, Kejiao Building (No. 6), No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, China
| | - Tao Lin
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics Chongqing, Room 806, Kejiao Building (No. 6), No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Da-Wei He
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics Chongqing, Room 806, Kejiao Building (No. 6), No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Sheng-De Wu
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China. .,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China. .,National Clinical Research Center for Child Health and Disorders, Chongqing, China. .,Chongqing Key Laboratory of Pediatrics Chongqing, Room 806, Kejiao Building (No. 6), No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, China. .,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China. .,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.
| | - Guang-Hui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics Chongqing, Room 806, Kejiao Building (No. 6), No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
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Vasta LM, McMaster ML, Harney LA, Ling A, Kim J, Harris AK, Carr AG, Damrauer SM, Rader DJ, Kember RL, Kanetsky PA, Nathanson KL, Pyle LC, Greene MH, Schultz KA, Stewart DR. Lack of pathogenic germline DICER1 variants in males with testicular germ-cell tumors. Cancer Genet 2020; 248-249:49-56. [PMID: 33158809 DOI: 10.1016/j.cancergen.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several studies have reported conflicting evidence on the inclusion of testicular germ cell tumors (TGCT) in the DICER1 tumor-predisposition phenotype. We evaluated the relationship between DICER1 and TGCT by reviewing scrotal ultrasounds of males with pathogenic germline variants in DICER1 and queried exome data from TGCT-affected men for DICER1 variants. METHODOLOGY Fifty-four male DICER1-carriers and family controls (n=41) enrolled in the National Cancer Institute (NCI) DICER1 Natural History Study were offered scrotal ultrasounds. These studies were examined by a single radiologist for abnormalities. In parallel, DICER1 variants from two large exome-sequenced TGCT cohorts were extracted. We used previously published AMG-AMP criteria to characterize rare DICER1 variants. RESULTS There was no observed difference in frequency of testicular cystic structures in DICER1-carriers versus controls. DICER1 variation was not associated with TGCT in the NCI DICER1-carriers. In 1,264 exome-sequenced men with TGCT, none harbored ClinVar- or InterVar-determined pathogenic or likely pathogenic variants in DICER1. Three DICER1 variants of uncertain significance (one case and two controls) were predicted "damaging" based on a priori criteria. CONCLUSION Using two complementary approaches, we found no evidence of an association between pathogenic DICER1 variants and TGCT.
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Affiliation(s)
- Lauren M Vasta
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA; National Capital Consortium, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Mary L McMaster
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA; Commissioned Corps of the United States Public Health Service
| | | | - Alexander Ling
- Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Jung Kim
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Anne K Harris
- International Pleuropulmonary Blastoma/DICER1 Registry, Minneapolis, MN, USA
| | - Ann G Carr
- Commissioned Corps of the United States Public Health Service
| | - Scott M Damrauer
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Daniel J Rader
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rachel L Kember
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Katherine L Nathanson
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Louise C Pyle
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Kris Ann Schultz
- International Pleuropulmonary Blastoma/DICER1 Registry, Minneapolis, MN, USA; Cancer and Blood Disorders, Children's Minnesota, International Pleuropulmonary Blastoma/DICER1 Registry, Minneapolis, MN, USA; International Ovarian and Testicular Stromal Tumor Registry, Children's Minnesota, Minneapolis, MN, USA
| | - Douglas R Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
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Dantsev IS, Ivkin EV, Tryakin AA, Godlevski DN, Latyshev OY, Rudenko VV, Mikhaylenko DS, Chernykh VB, Volodko EA, Okulov AB, Loran OB, Nemtsova MV. Genes associated with testicular germ cell tumors and testicular dysgenesis in patients with testicular microlithiasis. Asian J Androl 2019; 20:593-599. [PMID: 30027931 PMCID: PMC6219295 DOI: 10.4103/aja.aja_54_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Testicular microlithiasis (TM) is one of the symptoms of testicular dysgenesis syndrome (TDS). TM is particularly interesting as an informative marker of testicular germ cell tumors (TGCTs). KIT ligand gene (KITLG), BCL2 antagonist/killer 1 (BAK1), and sprouty RTK signaling antagonist 4 (SPRY4) genes are associated with a high risk of TGCTs, whereas bone morphogenetic protein 7 gene (BMP7), transforming growth factor beta receptor 3 gene (TGFBR3), and homeobox D cluster genes (HOXD) are related to TDS. Using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis, we investigated allele and genotype frequencies for KITLG (rs995030, rs1508595), SPRY4 (rs4624820, rs6897876), BAK1 (rs210138), BMP7 (rs388286), TGFBR3 (rs12082710), and HOXD (rs17198432) in 142 TGCT patients, 137 TM patients, and 153 fertile men (control group). We found significant differences in the KITLG GG_rs995030 genotype in TM (P = 0.01) and TGCT patients (P = 0.0005) compared with the control. We also revealed strong associations between KITLG_rs1508595 and TM (G allele, P = 0.003; GG genotype, P = 0.01) and between KITLG_rs1508595 and TGCTs (G allele, P = 0.0001; GG genotype, P = 0.0007). Moreover, there was a significant difference in BMP7_rs388286 between the TGCT group and the control (T allele, P = 0.00004; TT genotype, P = 0.00006) and between the TM group and the control (T allele, P = 0.04). HOXD also demonstrated a strong association with TGCTs (rs17198432 A allele, P = 0.0001; AA genotype, P = 0.001). Furthermore, significant differences were found between the TGCT group and the control in the BAK1_rs210138 G allele (P = 0.03) and the GG genotype (P = 0.01). KITLG and BMP7 genes, associated with the development of TGCTs, may also be related to TM. In summary, the KITLG GG_rs995030, GG_rs1508595, BMP7 TT_rs388286, HOXD AA_rs17198432, and BAK1 GG_rs210138 genotypes were associated with a high risk of TGCT development.
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Affiliation(s)
- Ilya S Dantsev
- Russian Medical Academy of Postgraduate Education, Moscow 123995, Russia
| | - Evgeniy V Ivkin
- Russian Medical Academy of Postgraduate Education, Moscow 123995, Russia
| | | | | | - Oleg Yu Latyshev
- Russian Medical Academy of Postgraduate Education, Moscow 123995, Russia
| | | | | | - Vyacheslav B Chernykh
- Research Centre of Medical Genetics, Moscow 115478, Russia.,N. I. Pirogov Russian National Research Medical University, Moscow 117997, Russia
| | - Elena A Volodko
- Russian Medical Academy of Postgraduate Education, Moscow 123995, Russia
| | - Aleksey B Okulov
- Russian Medical Academy of Postgraduate Education, Moscow 123995, Russia
| | - Oleg B Loran
- Russian Medical Academy of Postgraduate Education, Moscow 123995, Russia
| | - Marina V Nemtsova
- Research Centre of Medical Genetics, Moscow 115478, Russia.,I. M. Sechenov First Moscow State Medical University, Moscow 119991, Russia
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Pedersen MR, Møller H, Rafaelsen SR, Møller JK, Osther PJS, Vedsted P. Association between risk factors and testicular microlithiasis. Acta Radiol Open 2019; 8:2058460119870297. [PMID: 31588363 PMCID: PMC6740053 DOI: 10.1177/2058460119870297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 07/26/2019] [Indexed: 11/16/2022] Open
Abstract
Background Testicular microlithiasis and its clinical significance are not fully understood. Testicular microlithiasis and risk factors have been associated with testicular cancer. The role of testicular microlithiasis is investigated. Purpose To investigate the association between testicular microlithiasis and socioeconomic and other pre-diagnostic factors. Material and Methods All men who had a scrotal ultrasound examination at the Department of Radiology, Vejle Hospital, during 2001–2013 were included. They were categorized as patients with and without testicular microlithiasis and compared with pre-diagnostic data from a nationwide registry. A total of 2404 men (283 [11.8%] with testicular microlithiasis and 2121 [88.2%] without testicular microlithiasis) were included. The association between testicular microlithiasis and pre-diagnostic conditions was investigated with logistic regression. Results Overall, we found no statistically significant differences in demographics, socioeconomic characteristics, or testicular diseases in men with and without testicular microlithiasis. Men with testicular microlithiasis had more often been treated for infertility (odds ratio [OR] 2.09, 95% confidence interval [CI] 0.84–5.24) and testicular torsion (OR 1.58, 95% CI 0.34–7.36) compared to men without testicular microlithiasis. We found no association between sexually transmitted diseases and testicular microlithiasis. Conclusion Treatment for infertility and torsion was non-significantly associated with testicular microlithiasis and no other association was found. These data do not suggest early exposure is related to testicular microlithiasis.
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Affiliation(s)
- Malene Roland Pedersen
- Department of Radiology, Vejle Hospital, Vejle, Denmark.,Urological Research Centre, Department of Urology, Vejle Hospital, Vejle, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Henrik Møller
- Cancer Epidemiology and Population Health, King's College London, London, United Kingdom.,Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Søren Rafael Rafaelsen
- Department of Radiology, Vejle Hospital, Vejle, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jens Kjølseth Møller
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Microbiology, Clinical Cancer Center, Vejle Hospital, Vejle, Denmark
| | - Palle Jørn Sloth Osther
- Urological Research Centre, Department of Urology, Vejle Hospital, Vejle, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Peter Vedsted
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Aoun F, Slaoui A, Naoum E, Hassan T, Albisinni S, Azzo JM, Kallas-Chemaly A, Assenmacher G, Peltier A, Roumeguère T. Testicular microlithiasis: Systematic review and Clinical guidelines. Prog Urol 2019; 29:465-473. [DOI: 10.1016/j.purol.2019.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/24/2019] [Accepted: 07/02/2019] [Indexed: 12/22/2022]
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Leblanc L, Lagrange F, Lecoanet P, Marçon B, Eschwege P, Hubert J. Testicular microlithiasis and testicular tumor: a review of the literature. Basic Clin Androl 2018; 28:8. [PMID: 30002831 PMCID: PMC6036676 DOI: 10.1186/s12610-018-0073-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/24/2018] [Indexed: 11/15/2022] Open
Abstract
Introduction There are numerous scientific publications on testicular microlithiasis (TML) detected during ultrasound (US) examination. We wished to update the data. Methods PubMed was used to identify original articles published between 1998 and May 2017 describing the association between TML and testicular tumor. Studies were only included if TML was diagnosed by US. Studies were then classified into subgroups according to the following criteria: asymptomatic, symptomatic, infertility, cryptorchidism, family or personal history of testicular cancer, and “no given reason for US”. A Z-Test was used to identify differences within these subgroups. In addition, we identified prospective cohorts of TML patients. Numbers, duration of follow-up, and occurrence of the “testicular tumor” event were recorded for each of them. Results One hundred and seventy-five articles were identified, 40 of which were included. Our review has not showed a clear evidence that cryptorchidism associated with TML is a risk factor for testicular tumor. However, there seems to be a correlation between infertility associated with TML and a higher tumor risk. There were not enough studies to confirm a relationship between family or personal history associated with TML and the tumor risk. There was also a correlation with a higher tumor risk for symptomatic associated with TML and “no given reason for US” plus TML groups. However, these groups are assumed to contain bias and caution must be taken regarding conclusions. Regarding the prospective cohort studies, 16 testicular tumors appeared in the follow-up of patients with TML, 13 patients had risk factors. Conclusion In cases of TML incidental finding by US with the presence of risk factors (personal history of testicular cancer, testicular atrophy, infertility, cryptorchidism) a consultation with a specialist should be considered. In the absence of risk factors, the occurrence of testicular cancer in patients with TML is similar to the risk of the general population.
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Affiliation(s)
| | | | | | | | - Pascal Eschwege
- 1Department of Urology, CHRU Nancy, Nancy, France.,2CNRS UMR 7039 CRAN, Lorraine University, Nancy, France
| | - Jacques Hubert
- 1Department of Urology, CHRU Nancy, Nancy, France.,3IADI-UL-Inserm (U947), Lorraine University, Nancy, France
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8
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Epigenetics and testicular germ cell tumors. Gene 2018; 661:22-33. [PMID: 29605605 DOI: 10.1016/j.gene.2018.03.072] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 02/07/2018] [Accepted: 03/21/2018] [Indexed: 11/20/2022]
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9
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Machiela MJ, Dagnall CL, Pathak A, Loud JT, Chanock SJ, Greene MH, McGlynn KA, Stewart DR. Mosaic chromosome Y loss and testicular germ cell tumor risk. J Hum Genet 2017; 62:637-640. [PMID: 28275244 PMCID: PMC5444985 DOI: 10.1038/jhg.2017.20] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 12/23/2022]
Abstract
Studies have suggested mosaic loss of chromosome Y (mLOY) in blood-derived DNA is common in older men. Cohort studies investigating mLOY and mortality have reported contradictory results. Previous work found a 1.6 Mb deletion of the AZFc region on the Y chromosome (the “gr/gr” deletion) is associated with both male infertility and increased risk of testicular germ cell tumors (TGCT). We investigated whether mosaic loss across the entire Y chromosome was associated with TGCT. We obtained blood and buccal-derived DNA from two case-control studies: the NCI Familial Testicular Cancer Study (FTC; cases=172, controls=163) and the NCI US Servicemen's Testicular Tumor Environmental and Endocrine Determinants Study (STEED; cases=506, controls=611). We utilized 15 quantitative polymerase chain reactions (qPCR) spanning the Y chromosome to assess mLOY. Multivariate logistic regression models adjusted for study batch effects detected no significant overall relationship between mean chromosome Y T/R ratio and TGCT (OR=0.34, 95% CI=0.10–1.17, P=0.09). When restricted to familial TGCT cases, a significantly lower T/R ratio was observed in cases compared with controls (0.993 vs 1.014, P-value=0.01). Our study suggests mLOY, as measured by 15 probes spanning the Y chromosome, could be associated with familial TGCT, but larger studies are required to confirm this observation.
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Affiliation(s)
- Mitchell J Machiela
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Casey L Dagnall
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.,Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, MD, USA
| | - Anand Pathak
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jennifer T Loud
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Mark H Greene
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Douglas R Stewart
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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10
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Pedersen MR, Osther PJS, Soerensen FB, Rafaelsen SR. Testicular Microlithiasis: Patient Compliance in a Two-Year Follow-Up Program. Ultrasound Int Open 2016; 2:E113-E116. [PMID: 27921092 DOI: 10.1055/s-0042-113776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/21/2016] [Indexed: 10/21/2022] Open
Abstract
Introduction: We present a retrospective 2-year follow-up cohort of 103 men with testicular microlithiasis (TML) and discuss patient compliance and the value of surveillance. Methods: A retrospective analysis of patients examined with scrotal ultrasonography (US) in the period from 2008 through 2010 was performed. A total of 103 men with TML were diagnosed and offered US follow-up every 6 months for 2 years. They were retrospectively analyzed regarding demographics and follow-up details, including the development of any kind of malignancy until March 2015, using the Danish Electronic Pathology Registry. Results: The prevalence of TML was 10.3%. Of the 103 men with TML, 23 (22.3%) had TML in the left testicle, 38 (36.9%) in the right (p=0.002), and 42 (40.8%) had bilateral TML. Patient compliance was low with 11.7% participating in all US follow-up examinations. 5 men presented risk factors (testicular atrophy (N=1) and previous testicular cancer (N=4)), but no cases of testicular malignancy were found in the follow-up period. Conclusion: The low patient compliance conflicts with the ESUR Scrotal Imaging Subcommittee guidelines that recommend scrotal US follow-up annually for TML until the age of 55 years. The fact that no cancers were found during follow-up using the pathology registry calls the value of follow-up into question.
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Affiliation(s)
- M R Pedersen
- Radiology, Vejle Hospital - Part of Sygehus Lillebaelt, Vejle, Denmark
| | - P J S Osther
- Urological Research Centre, Fredercia Hospital - Part of Sygehus Lillebaelt, Fredericia, Denmark
| | - F B Soerensen
- Clinical Pathology, Sygehus Lillebalt Vejle Sygehus, Vejle, Denmark
| | - S R Rafaelsen
- Department of Radiology, DCCG South Vejle Hospital, Vejle, Denmark
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Pedersen MR, Graumann O, Hørlyck A, Duus LA, Jørgensen MMB, Vagn-Hansen C, Holst R, Rafaelsen SR. Inter- and intraobserver agreement in detection of testicular microlithiasis with ultrasonography. Acta Radiol 2016; 57:767-72. [PMID: 26419255 DOI: 10.1177/0284185115604516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 08/12/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ultrasonography of the testis is a well-established diagnostic tool in detection of testicular microlithiasis (TML). Operator-dependent diagnostic variation related to skill, knowledge, and operator consistency are factors that influence detection of TML. PURPOSE To determine inter- and intraobserver agreement for detection of TML using ultrasonography for a group of physicians with no or limited experience compared to a group of experience senior radiologists. MATERIAL AND METHODS Between May and September 2014 a total of six observers evaluated 34 patients scrotal ultrasonography recorded from September to December 2013. The observers were blinded to patient history and previous ultrasonography. Three of the observers had no or limited experience with detection of TML, and three of the observers had more than 15 years of experience. Each observer reviewed all the scrotal ultrasonography recordings twice with a time interval of 3 months. RESULTS The inter-observer agreement showed substantial agreement and up to almost perfect agreement (κ = 0.86). Both the experienced and less experienced observers had a higher agreement in detecting and grading TML in their second reading. CONCLUSION The ultrasonography grading system of TML in this study showed to be reproducible, with an inter- and intraobserver agreement ranging between substantial agreement and up to almost perfect agreement with many years of experience not necessarily being essential.
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Affiliation(s)
- Malene Roland Pedersen
- Department of Radiology, Lillebaelt Hospital, Vejle, Denmark
- Urological Research Center, Department of Urology, Lillebaelt Hospital, Fredericia, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - Ole Graumann
- Department of Radiology, Aarhus University Hospital, Skejby, Denmark
- CECLUS, Center of Clinical Ultrasound, Aarhus University, Denmark
| | - Arne Hørlyck
- Department of Radiology, Aarhus University Hospital, Skejby, Denmark
- CECLUS, Center of Clinical Ultrasound, Aarhus University, Denmark
| | | | | | | | - René Holst
- Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - Søren Rafael Rafaelsen
- Department of Radiology, Lillebaelt Hospital, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Denmark
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Nistal M, Paniagua R, González-Peramato P, Reyes-Múgica M. Perspectives in Pediatric Pathology, Chapter 13. Calcifications in the Testis and Paratesticular Structures. Pediatr Dev Pathol 2016; 19:173-82. [PMID: 25105530 DOI: 10.2350/14-04-1475-pb.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Manuel Nistal
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo No. 2, Madrid 28029, Spain
| | - Ricardo Paniagua
- 2 Department of Cell Biology, Universidad de Alcala, Madrid, Spain
| | - Pilar González-Peramato
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo No. 2, Madrid 28029, Spain
| | - Miguel Reyes-Múgica
- 3 Department of Pathology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
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13
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Testicular microlithiasis and testicular cancer: review of the literature. Int Urol Nephrol 2016; 48:1079-86. [DOI: 10.1007/s11255-016-1267-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 03/11/2016] [Indexed: 11/26/2022]
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Abstract
Germ cell tumors (GCT) are relatively uncommon, accounting for only 1% of male malignancies in the United States. It has become an important oncological disease for several reasons. It is the most common malignancy in young men 15-35 years old. GCTs are among a unique numbers of neoplasms where biochemical markers play a critical role. Finally, it is a model of curable cancer. In this review we discuss cancer epidemiology, genetics, and therapeutic principles. Recent advances in the management of stage I GCT and controversies in the management of post chemotherapy residual mass are presented.
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Affiliation(s)
- Yaron Ehrlich
- 1 Department of Urology, Rabin Medical Centre Beilinson Campus, Petah Tiqwa, Israel ; 2 Sackler Medical School, Tel Aviv University, P.O. Box 39040, Tel Aviv 69978, Israel
| | - David Margel
- 1 Department of Urology, Rabin Medical Centre Beilinson Campus, Petah Tiqwa, Israel ; 2 Sackler Medical School, Tel Aviv University, P.O. Box 39040, Tel Aviv 69978, Israel
| | - Marc Alan Lubin
- 1 Department of Urology, Rabin Medical Centre Beilinson Campus, Petah Tiqwa, Israel ; 2 Sackler Medical School, Tel Aviv University, P.O. Box 39040, Tel Aviv 69978, Israel
| | - Jack Baniel
- 1 Department of Urology, Rabin Medical Centre Beilinson Campus, Petah Tiqwa, Israel ; 2 Sackler Medical School, Tel Aviv University, P.O. Box 39040, Tel Aviv 69978, Israel
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Pathak A, Adams CD, Loud JT, Nichols K, Stewart DR, Greene MH. Prospectively Identified Incident Testicular Cancer Risk in a Familial Testicular Cancer Cohort. Cancer Epidemiol Biomarkers Prev 2015; 24:1614-21. [PMID: 26265202 DOI: 10.1158/1055-9965.epi-14-1240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 07/28/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Human testicular germ cell tumors (TGCT) have a strong genetic component and a high familial relative risk. However, linkage analyses have not identified a rare, highly penetrant familial TGCT (FTGCT) susceptibility locus. Currently, multiple low-penetrance genes are hypothesized to underlie the familial multiple-case phenotype. The observation that two is the most common number of affected individuals per family presents an impediment to FTGCT gene discovery. Clinically, the prospective TGCT risk in the multiple-case family context is unknown. METHODS We performed a prospective analysis of TGCT incidence in a cohort of multiple-affected-person families and sporadic-bilateral-case families; 1,260 men from 140 families (10,207 person-years of follow-up) met our inclusion criteria. Age-, gender-, and calendar time-specific standardized incidence ratios (SIR) for TGCT relative to the general population were calculated using SEER*Stat. RESULTS Eight incident TGCTs occurred during prospective FTGCT cohort follow-up (versus 0.67 expected; SIR = 11.9; 95% CI, 5.1-23.4; excess absolute risk = 7.2/10,000). We demonstrate that the incidence rate of TGCT is greater among bloodline male relatives from multiple-case testicular cancer families than that expected in the general population, a pattern characteristic of adult-onset Mendelian cancer susceptibility disorders. Two of these incident TGCTs occurred in relatives of sporadic-bilateral cases (0.15 expected; SIR = 13.4; 95% CI, 1.6-48.6). CONCLUSIONS Our data are the first to indicate that despite relatively low numbers of affected individuals per family, members of both multiple-affected-person FTGCT families and sporadic-bilateral TGCT families comprise high-risk groups for incident testicular cancer. IMPACT Men at high TGCT risk might benefit from tailored risk stratification and surveillance strategies.
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Affiliation(s)
- Anand Pathak
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Charleen D Adams
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Jennifer T Loud
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | | | - Douglas R Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland.
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Rahimi R, Foroughi AA, Haghpanah S, Bahmanyar M, Jelodari S, De Sanctis V, Karimi M. Incidence of testicular microlithiasis in patients with β-thalassemia major. Ann Hematol 2015; 94:1785-9. [DOI: 10.1007/s00277-015-2465-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 07/21/2015] [Indexed: 11/29/2022]
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Richenberg J, Belfield J, Ramchandani P, Rocher L, Freeman S, Tsili AC, Cuthbert F, Studniarek M, Bertolotto M, Turgut AT, Dogra V, Derchi LE. Testicular microlithiasis imaging and follow-up: guidelines of the ESUR scrotal imaging subcommittee. Eur Radiol 2014; 25:323-30. [DOI: 10.1007/s00330-014-3437-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/25/2014] [Accepted: 09/08/2014] [Indexed: 11/28/2022]
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Greene MH, Mai PL, Loud JT, Pathak A, Peters JA, Mirabello L, McMaster ML, Rosenberg P, Stewart DR. Familial testicular germ cell tumors (FTGCT) - overview of a multidisciplinary etiologic study. Andrology 2014; 3:47-58. [PMID: 25303766 DOI: 10.1111/andr.294] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/08/2014] [Accepted: 09/15/2014] [Indexed: 02/06/2023]
Abstract
This Review summarizes the cumulative results of the National Cancer Institute Clinical Genetics Branch Multidisciplinary Etiologic Study of Familial Testicular Germ Cell Tumors (FTGCT). Initiated 12 years ago, this protocol enrolled 724 subjects from 147 unrelated families with either ≥2 affected men (n = 90) with TGCT or a proband with bilateral TGCT and a negative family history for this cancer (n = 57). Data were collected directly from 162 subjects evaluated at the NIH Clinical Center, and 562 subjects provided information from their home communities (Field Cohort). The primary study aims included (i) ascertaining, enrolling eligible FTGCT kindred, (ii) characterizing the clinical phenotype of multiple-case families, (iii) identifying the underlying genetic mechanism for TGCT susceptibility in families, (iv) evaluating counseling, psychosocial, and behavioral issues resulting from membership in an FTGCT family, and (v) creating an annotated biospecimen repository to permit subsequent translational research studies. Noteworthy findings include (i) documenting the epidemiologic similarities between familial and sporadic TGCT, (ii) demonstrating significantly younger age-at-diagnosis for familial vs. sporadic TGCT, (iii) absence of a dysmorphic phenotype in affected family members, (iv) shifting the focus of gene discovery from a search for rare, highly penetrant susceptibility variants to the hypothesis that multiple, more common, lower penetrance genes underlie TGCT genetic risk, (v) implicating testicular microlithiasis in FTGCT risk, and (vi) observing that aberrant methylation may contribute to FTGCT risk. A clinically based, biospecimen-intensive, multidisciplinary research strategy has provided novel, valuable insights into the etiology of FTGCT, and created a research resource which will support FTGCT clinical and laboratory studies for years to come.
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Affiliation(s)
- M H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Xu C, Liu M, Zhang FF, Liu JL, Jiang XZ, Teng JB, Xuan XJ, Ma JL. The Association Between Testicular Microlithiasis and Semen Parameters in Chinese Adult Men With Fertility Intention: Experience of 226 Cases. Urology 2014; 84:815-20. [DOI: 10.1016/j.urology.2014.03.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 03/13/2014] [Accepted: 03/17/2014] [Indexed: 10/24/2022]
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20
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Chihara M, Nakamura T, Sakakibara N, Otsuka S, Ichii O, Kon Y. The Onset of Heat-Induced Testicular Calcification in Mice. THE AMERICAN JOURNAL OF PATHOLOGY 2014; 184:2480-92. [DOI: 10.1016/j.ajpath.2014.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 05/29/2014] [Accepted: 06/04/2014] [Indexed: 11/27/2022]
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Mueller CM, Korde LA, McMaster ML, Peters JA, Bratslavsky G, Watkins RJ, Ling A, Kratz CP, Wulfsberg EA, Rosenberg PS, Greene MH. Familial testicular germ cell tumor: no associated syndromic pattern identified. Hered Cancer Clin Pract 2014; 12:3. [PMID: 24559313 PMCID: PMC3937045 DOI: 10.1186/1897-4287-12-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 02/12/2014] [Indexed: 11/10/2022] Open
Abstract
Background Testicular germ cell tumor (TGCT) is the most common malignancy in young men. Familial clustering, epidemiologic evidence of increased risk with family or personal history, and the association of TGCT with genitourinary (GU) tract anomalies have suggested an underlying genetic predisposition. Linkage data have not identified a rare, highly-penetrant, single gene in familial TGCT (FTGCT) cases. Based on its association with congenital GU tract anomalies and suggestions that there is an intrauterine origin to TGCT, we hypothesized the existence of unrecognized dysmorphic features in FTGCT. Methods We evaluated 38 FTGCT individuals and 41 first-degree relatives from 22 multiple-case families with detailed dysmorphology examinations, physician-based medical history and physical examination, laboratory testing, and genitourinary imaging studies. Results The prevalence of major abnormalities and minor variants did not significantly differ between either FTGCT individuals or their first-degree relatives when compared with normal population controls, except for tall stature, macrocephaly, flat midface, and retro-/micrognathia. However, these four traits were not manifest as a constellation of features in any one individual or family. We did detect an excess prevalence of the genitourinary anomalies cryptorchidism and congenital inguinal hernia in our population, as previously described in sporadic TGCT, but no congenital renal, retroperitoneal or mediastinal anomalies were detected. Conclusions Overall, our study did not identify a constellation of dysmorphic features in FTGCT individuals, which is consistent with results of genetic studies suggesting that multiple low-penetrance genes are likely responsible for FTGCT susceptibility.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Mullooly C, Hickerton B, Weston R, Woolley PD. Testicular microlithiasis: is it significant? Int J STD AIDS 2013; 23:620-2. [PMID: 23033512 DOI: 10.1258/ijsa.2012.011444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Previously considered to be a benign finding on scrotal ultrasonography, testicular microlithiasis (TM) is now recognized as a condition associated with the development of testicular neoplasia. Despite this the management of TM remains unclear. We review the evidence for this association and suggested management strategies.
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Affiliation(s)
- C Mullooly
- Department of Sexual Medicine and HIV, University Hospitals of South Manchester, West Didsbury, Manchester, UK.
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Clinical aspects of testicular microlithiasis in boys: a review. J Pediatr Urol 2012; 8:459-69. [PMID: 21856234 DOI: 10.1016/j.jpurol.2011.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 07/07/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE After review of the pediatric literature, we report on the prevalence of testicular microlithiasis and its relation with benign and malign entities. We provide a guideline for the management of boys with testicular microlithiasis. MATERIALS AND METHODS The databases searched were Medline, Web of Science, Embase and the Cochrane Library. Data on the rates of testicular microlithiasis were collected and from each study information was extracted on the study population according to country, study design, diagnostic method, type of patient, number of patients, age, associated anomalies, additional diagnostic methods and follow-up information. From the 472 articles, we selected 126 articles as potentially relevant, of which 57 were included. RESULTS In asymptomatic boys, the prevalence of testicular microlithiasis is 4.2% and in symptomatic referrals it is 1.6%. The development of a testicular malignancy is occasionally reported after diagnosis of testicular microlithiasis. The management of boys with testicular microlithiasis varies widely. Most authors recommend regular self-examination, and some perform testicular ultrasound and/or screen tumor markers. CONCLUSION The prevalence of testicular microlithiasis in boys varies between 1.1% and 4.2%. For follow-up, regular self-examination is advised from the age of 15 years.
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Mirabello L, Kratz CP, Savage SA, Greene MH. Promoter methylation of candidate genes associated with familial testicular cancer. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2012; 3:213-227. [PMID: 23050052 PMCID: PMC3459216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 07/29/2012] [Indexed: 06/01/2023]
Abstract
Recent genomic studies have identified risk SNPs in or near eight genes associated with testicular germ cell tumors (TGCT). Mouse models suggest a role for Dnd1 epigenetics in TGCT susceptibility, and we have recently reported that transgenerational inheritance of epigenetic events may be associated with familial TGCT risk. We now investigate whether aberrant promoter methylation of selected candidate genes is associated with familial TGCT risk. Pyrosequencing assays were designed to evaluate CpG methylation in the promoters of selected genes in peripheral blood DNA from 153 TGCT affecteds and 116 healthy male relatives from 101 multiple-case families. Wilcoxon rank-sum tests and logistic regression models were used to investigate associations between promoter methylation and TGCT. We also quantified gene product expression of these genes, using quantitative PCR. We observed increased PDE11A, SPRY4 and BAK1 promoter methylation, and decreased KITLG promoter methylation, in familial TGCT cases versus healthy male family controls. A significant upward risk trend was observed for PDE11A when comparing the middle and highest tertiles of methylation to the lowest [odds ratio (OR) =1.55, 95% confidence intervals (CI) 0.82-2.93, and 1.94, 95% CI 1.03-3.66], respectively; P(trend)=0.042). A significant inverse association was observed for KITLG when comparing the middle and lowest tertiles to the highest (OR=2.15, 95% CI 1.12-4.11, and 2.15, 95% CI 1.12-4.14, respectively; P(trend)=0.031). There was a weak inverse correlation between promoter methylation and KITLG expression. Our results suggest that familial TGCT susceptibility may be associated with promoter methylation of previously-identified TGCT risk-modifying genes. Larger studies are warranted.
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Peters JA, Kenen R, Hoskins LM, Glenn GM, Kratz C, Greene MH. Close ties: an exploratory Colored Eco-Genetic Relationship Map (CEGRM) study of social connections of men in Familial Testicular Cancer (FTC) families. Hered Cancer Clin Pract 2012; 10:2. [PMID: 22381132 PMCID: PMC3323467 DOI: 10.1186/1897-4287-10-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 03/01/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Testicular cancer, while rare compared with other adult solid tumors, is the most common cancer in young men in northern Europe and North America. Risk factors include white race, positive family history, contralateral testicular cancer, cryptorchidism, infertility and testicular microlithiasis. As the genetic causes of familial clusters (Familial Testicular Cancer or FTC) are being sought, it is also important to understand the psycho-social experiences of members of FTC families. METHODS This is a cross-sectional examination via the Colored Eco-Genetic Relationship Map (CEGRM) of social connections reported by 49 men in FTC families participating in NCI research study 02-C-178. RESULTS The CEGRM was acceptable and feasible for use with men in FTC families, and valuable in understanding their social connections. These men have largely adjusted to the TC history in themselves and/or their relatives. They have considerable social and emotional support from family and friends, although there is wide variability in sources and types. CONCLUSIONS The CEGRM focuses on men's social connections and close emotional bonds in FTC families. This action-oriented process of placing colored symbols on significant relationships uncovered previously under-appreciated emotions accompanying men's social exchanges. Most men in FTC families succeed in re-establishing a sense of normalcy in their lives and social connections, in the aftermath of a testicular cancer diagnosis.
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Affiliation(s)
- June A Peters
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, 6120 Executive Blvd, Rockville, MD, 20852 USA.
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Kratz CP, Han SS, Rosenberg PS, Berndt SI, Burdett L, Yeager M, Korde LA, Mai PL, Pfeiffer R, Greene MH. Variants in or near KITLG, BAK1, DMRT1, and TERT-CLPTM1L predispose to familial testicular germ cell tumour. J Med Genet 2011; 48:473-6. [PMID: 21617256 PMCID: PMC3131696 DOI: 10.1136/jmedgenet-2011-100001] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Familial testicular germ cell tumours (TGCTs) and bilateral TGCTs comprise 1-2% and 5% of all TGCTs, respectively, but their genetic basis remains largely unknown. AIM To investigate the contribution of known testicular cancer risk variants in familial and bilateral TGCTs. METHODS AND RESULTS The study genotyped 106 single nucleotide polymorphisms (SNPs) in four regions (BAK1, DMRT1, KITLG, TERT-CLPTM1L) previously identified from genome-wide association studies of TGCT, including risk single nucleotide polymorphisms (SNPs) rs210138 (BAK1), rs755383 (DMRT1), rs4635969 (TERT-CLPTM1L) in 97 cases with familial TGCT and 22 affected individuals with sporadic bilateral TGCT as well as 871 controls. Using a generalised estimating equations method that takes into account blood relationships among cases, the associations with familial and bilateral TGCT were analysed. Three previously identified risk SNPs were found to be associated with familial and bilateral TGCT (rs210138: OR 1.80, CI 1.35 to 2.41, p=7.03×10(-5); rs755383: OR 1.67, CI 1.23 to 2.22, p=6.70×10(-4); rs4635969: OR 1.59, CI 1.16 to 2.19, p=4.07×10(-3)). Evidence for a second independent association was found for an SNP in TERT (rs4975605: OR 1.68, CI 1.23 to 2.29, p=1.24×10(-3)). Another association with an SNP was identified in KITLG (rs2046971: OR 2.33, p=1.28×10(-3)); this SNP is in high linkage disequilibrium (LD) with reported risk variant rs995030. CONCLUSION This study provides evidence for replication of recent genome-wide association studies results and shows that variants in or near BAK1, DMRT1, TERT-CLPTM1L, and KITLG predispose to familial and bilateral TGCT. These findings imply that familial TGCT and sporadic TGCT share a common genetic basis.
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Affiliation(s)
- Christian P Kratz
- Division of CancerEpidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland 20852, USA.
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Tan IB, Ang KK, Ching BC, Mohan C, Toh CK, Tan MH. Testicular microlithiasis predicts concurrent testicular germ cell tumors and intratubular germ cell neoplasia of unclassified type in adults. Cancer 2010; 116:4520-32. [DOI: 10.1002/cncr.25231] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rapley EA, Nathanson KL. Predisposition alleles for testicular germ cell tumour. Curr Opin Genet Dev 2010; 20:225-30. [DOI: 10.1016/j.gde.2010.02.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 02/18/2010] [Accepted: 02/19/2010] [Indexed: 01/21/2023]
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Greene MH, Kratz CP, Mai PL, Mueller C, Peters JA, Bratslavsky G, Ling A, Choyke PM, Premkumar A, Bracci J, Watkins RJ, McMaster ML, Korde LA. Familial testicular germ cell tumors in adults: 2010 summary of genetic risk factors and clinical phenotype. Endocr Relat Cancer 2010; 17:R109-21. [PMID: 20228134 PMCID: PMC3101798 DOI: 10.1677/erc-09-0254] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Familial aggregations of testicular germ cell tumor (FTGCT) have been well described, suggesting the existence of a hereditary TGCT subset. Approximately 1.4% of newly diagnosed TGCT patients report a positive family history of TGCT. Sons and siblings of TGCT patients have four- to sixfold and eight- to tenfold increases in TGCT risk respectively. Segregation analyses suggest an autosomal recessive mode of inheritance. Linkage analyses have identified several genomic regions of modest interest, although no high-penetrance cancer susceptibility gene has been mapped yet. These data suggest that the combined effects of multiple common alleles, each conferring modest risk, might underlie familial testicular cancer. Families display a mild phenotype: the most common number of affected families is 2. Age at diagnosis is 2-3 years younger for familial versus sporadic cases. The ratio of familial seminoma to nonseminoma is 1.0. FTGCT is more likely to be bilateral than sporadic TGCT. This syndrome is cancer site specific. Testicular microlithiasis is a newly recognized FTGCT component. Candidate gene-association studies have implicated the Y chromosome gr/gr deletion and PDE11A gene mutations as genetic modifiers of FTGCT risk. Two genomewide association studies of predominantly sporadic but also familial cases of TGCT have implicated the KIT-ligand, SPRY4, and BAK1 genes as TGCT risk modifiers. All five loci are involved in normal testicular development and/or male infertility. These genetic data provide a novel insight into the genetic basis of FTGCT, and an invaluable guide to future TGCT research.
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Affiliation(s)
- Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20852, USA.
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Abstract
This article defines familial testicular germ cell tumours (FTGCTs) as testicular germ cell tumours (TGCTs) diagnosed in at least two blood relatives, a situation which occurs in 1-2% of all cases of TGCT. Brothers and fathers of TGCT patients have an 8-10- and 4-6-fold increased risk of TGCT, respectively, and an even higher elevated risk of TGCT in twin brothers of men with TGCT has been observed, suggesting that genetic elements play an important role in these tumours. Nevertheless, previous linkage studies with multiple FTGCT families did not uncover any high-penetrance genes and it has been concluded that the combined effects of multiple common alleles, each conferring a modest risk, might underlie FTGCT. In agreement with this assumption, recent candidate gene-association analyses have identified the chromosome Y gr/gr deletion and mutations in the PDE11A gene as genetic modifiers of FTGCT risk. Moreover, two genome-wide association studies of predominantly sporadic but also familial cases of TGCT have identified three additional susceptibility loci, KITLG, SPRY4 and BAK1. Notably, all five loci are involved in the biology of primordial germ cells, representing the cell of origin of TGCT, suggesting that the tumours arise as a result of disturbed testicular development.
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Affiliation(s)
| | | | - Mark H. Greene
- Corresponding author. Tel.: +1 301-594-7641 (M.H. Greene)
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Mirabello L, Savage SA, Korde L, Gadalla SM, Greene MH. LINE-1 methylation is inherited in familial testicular cancer kindreds. BMC MEDICAL GENETICS 2010; 11:77. [PMID: 20478068 PMCID: PMC2880977 DOI: 10.1186/1471-2350-11-77] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 05/17/2010] [Indexed: 11/23/2022]
Abstract
Background Testicular germ cell tumors (TGCT) are the most frequent cancers among young men. There is a clear familial component to TGCT etiology, but no high-penetrance susceptibility gene has been identified. Epigenetic aberrations of the genome represent an alternative mechanism for cancer susceptibility; and, studies suggest that epigenetic changes that influence cancer risk can be inherited through the germline. Global DNA hypomethylation has been associated with the risk of cancers of the bladder and head/neck. Methods We performed a pilot study of global methylation at long interspersed nuclear elements-1 (LINE-1) in peripheral blood DNA isolated from 466 family members of 101 multiple-case testicular cancer families. Results Investigating the correlation of LINE-1 methylation levels among parent-child pairs independent of affection status (n = 355) revealed a strong positive association only between mother-daughter (r = 0.48, P = <0.001) and father-daughter pairs (r = 0.31, P = 0.02), suggesting gender-specific inheritance of methylation. Incorporating cancer status, we observed a strong correlation in LINE-1 methylation levels only among affected father-affected son pairs (r = 0.49, P = 0.03). There was a marginally significant inverse association between lower LINE-1 methylation levels and increased TGCT risk, compared with healthy male relatives (P = 0.049). Conclusions Our data suggest that heritability of LINE-1 methylation may be gender-specific. Further, the strong correlation between LINE-1 methylation levels among affected father-affected son pairs suggests that transgenerational inheritance of an epigenetic event may be associated with disease risk. Larger studies are needed to clarify these preliminary observations.
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Affiliation(s)
- Lisa Mirabello
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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Abstract
PURPOSE OF REVIEW Testicular microlithiasis becomes a greater interdisciplinary issue among urologists, andrologists, gynecologists dedicated to reproductive medicine, pediatricians, radiologists and pathologists. Proposed management ranges from benign neglect, instructing self-examination over follow-up once, regular biannual follow-up including ultrasonography to bilateral testicular biopsy to rule out possible concomitant unclassified intratubular germ cell neoplasia (ITGCN) or future development of testicular cancer. The aim of this review is to present an overview of the current dilemma and summarize management trends based on the most recent data. RECENT FINDINGS Testicular microlithiasis is not a premalignant condition but may accompany ITGCN or testicular cancer. The importance of ruling out ITGCN with testicular biopsy in high-risk men, such as in those with bilateral testicular microlithiasis, infertility, cryptorchidism, atrophic testes or contralateral testicular cancer, has been recently advocated. SUMMARY Despite greater awareness of testicular microlithiasis, a clear definition is currently missing and the etiology is still obscure. This causes confusion in management and follow-up. Self-examination alone or in combination with testicular ultrasonography has been advised. Recently, a single set of biopsies in selected, high-risk groups has been proposed to rule out ITGCN without a need for further investigations apart from self-examination. However, the cost-effectiveness of such a strategy needs to be evaluated.
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Krohmer SJ, McNulty NJ, Schned AR. Testicular Seminoma with Lymph Node Metastases. Radiographics 2009; 29:2177-83. [DOI: 10.1148/rg.297085241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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O'Shaughnessy PJ, Monteiro A, Verhoeven G, De Gendt K, Abel MH. Occurrence of testicular microlithiasis in androgen insensitive hypogonadal mice. Reprod Biol Endocrinol 2009; 7:88. [PMID: 19712470 PMCID: PMC2744920 DOI: 10.1186/1477-7827-7-88] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 08/27/2009] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Testicular microliths are calcifications found within the seminiferous tubules. In humans, testicular microlithiasis (TM) has an unknown etiology but may be significantly associated with testicular germ cell tumors. Factors inducing microlith development may also, therefore, act as susceptibility factors for malignant testicular conditions. Studies to identify the mechanisms of microlith development have been hampered by the lack of suitable animal models for TM. METHODS This was an observational study of the testicular phenotype of different mouse models. The mouse models were: cryptorchid mice, mice lacking androgen receptors (ARs) on the Sertoli cells (SCARKO), mice with a ubiquitous loss of androgen ARs (ARKO), hypogonadal (hpg) mice which lack circulating gonadotrophins, and hpg mice crossed with SCARKO (hpg.SCARKO) and ARKO (hpg.ARKO) mice. RESULTS Microscopic TM was seen in 94% of hpg.ARKO mice (n=16) and the mean number of microliths per testis was 81+/-54. Occasional small microliths were seen in 36% (n=11) of hpg testes (mean 2+/-0.5 per testis) and 30% (n=10) of hpg.SCARKO testes (mean 8+/-6 per testis). No microliths were seen in cryptorchid, ARKO or SCARKO mice. There was no significant effect of FSH or androgen on TM in hpg.ARKO mice. CONCLUSION We have identified a mouse model of TM and show that lack of endocrine stimulation is a cause of TM. Importantly, this model will provide a means with which to identify the mechanisms of TM development and the underlying changes in protein and gene expression.
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Affiliation(s)
- Peter J O'Shaughnessy
- Institute of Comparative Medicine, Division of Cell Sciences, University of Glasgow Veterinary School, Bearsden Rd, Glasgow G61 1QH, UK
| | - Ana Monteiro
- Institute of Comparative Medicine, Division of Cell Sciences, University of Glasgow Veterinary School, Bearsden Rd, Glasgow G61 1QH, UK
| | - Guido Verhoeven
- Laboratory for Experimental Medicine and Endocrinology, Catholic University of Leuven, B-3000 Leuven, Belgium
| | - Karl De Gendt
- Laboratory for Experimental Medicine and Endocrinology, Catholic University of Leuven, B-3000 Leuven, Belgium
| | - Margaret H Abel
- Department of Human Anatomy and Genetics, University of Oxford, South Parks Rd, Oxford OX1 3QX, UK
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Vadaparampil ST, Moser RP, Loud J, Peters JA, Greene MH, Korde L. Factors associated with testicular self-examination among unaffected men from multiple-case testicular cancer families. Hered Cancer Clin Pract 2009; 7:11. [PMID: 19480691 PMCID: PMC2696412 DOI: 10.1186/1897-4287-7-11] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 05/29/2009] [Indexed: 11/26/2022] Open
Abstract
Background The lifetime testicular cancer (TC) risk in the general population is relatively low (~1 in 250), but men with a family history of TC are at 4 to 9 times greater risk than those without. Some health and professional organizations recommend consideration of testicular self-examination (TSE) for certain high-risk groups (e.g. men with a family history of TC). Yet little is known about factors associated with TSE behaviors in this at-risk group. Methods We collected information on this subject during an on-going NCI multidisciplinary, etiologically-focused, cross-sectional Familial Testicular Cancer (FTC) study. We present the first report specifically targeting TSE behaviors among first- and second-degree relatives (n = 99) of affected men from families with ≥ 2 TC cases. Demographic, medical, knowledge, health belief, and psychological factors consistent with the Health Belief Model (HBM) were evaluated as variables related to TSE behavior, using chi-square tests of association for categorical variables, and t-tests for continuous variables. Results For men in our sample, 46% (n = 46) reported performing TSE regularly and 51% (n = 50) reported not regularly performing TSE. Factors associated (p < .05) with regularly performing TSE in multivariate analysis were physician recommendation and testicular cancer worry. This is the first study to examine TSE in unaffected men from FTC families. Conclusion The findings suggest that, even in this high-risk setting, TSE practices are sub-optimal. Our data provide a basis for further exploring psychosocial issues that are specific to men with a family history of TC, and formulating intervention strategies aimed at improving adherence to TSE guidelines.
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