Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors

Kenneth A. Iczkowski, Samantha L. Butler, Jonathan H. Shanks, Deloar Hossain, Albrecht Schall, Isabelle Meiers, Ming Zhou, Kathleen C. Torkko, Stacy J. Kim, Gregory T. MacLennan

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Organic cation transporter 3/4 (OCT3/4) is a transcription factor of embryonic stem cells; c-kit (CD117) is a tyrosine kinase receptor implicated in seminoma carcinogenesis. Their reactivity is well characterized in testicular, but not extragonadal and metastatic, germ cell tumors. A total of 93 germ cell tumors (41 seminoma, 22 embryonal carcinoma, 18 teratoma, and 12 yolk sac tumor) were obtained from the central nervous system (30), mediastinum (23), retroperitoneum/abdomen (31), and other locations (9). Immunohistochemical staining for c-kit, placental-like alkaline phosphatase (PLAP), OCT3/4, and new markers D2-40 and AP-2γ was performed on seminomas; CD30 and epithelial membrane antigen were added for nonseminomas. In embryonal carcinoma, c-kit reacted in 17 of 22 cases, OCT3/4 in 18 of 22, and PLAP in 13 of 22. OCT3/4 was superior to PLAP in intensity and percent cells staining. In seminoma, OCT3/4 and D2-40 were superior to PLAP in intensity and percent cells; c-kit and AP-2γ were superior in percent cells. D2-40 stained 23 of 24 seminomas strongly but had only weak focal reactivity in 6 of 17 embryonal carcinomas. Sensitivity and specificity were high for OCT3/4 discriminating seminoma and embryonal carcinoma, and c-kit discriminating seminoma, from other germ cell tumors. For embryonal carcinoma, OCT3/4 had higher specificity (0.94) than CD30 (0.786) owing to CD30 reactivity in 3 of 10 teratomas. Epithelial membrane antigen discriminated teratoma from other nonseminomas with a sensitivity of 1 but reacted occasionally in embryonal carcinoma (3/15) and yolk sac tumor (2/7). In conclusion, for extragonadal seminoma, OCT3/4, AP-2γ, D2-40, and c-kit were equivalently superior to PLAP. For embryonal carcinoma, OCT3/4 was superior to PLAP and more specific than CD30. D2-40 is recommended to discriminate between seminoma and embryonal carcinoma.

Original languageEnglish (US)
Pages (from-to)275-281
Number of pages7
JournalHuman Pathology
Volume39
Issue number2
DOIs
StatePublished - Feb 1 2008

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Seminoma
Embryonal Carcinoma
Germ Cell and Embryonal Neoplasms
Germ Cells
Cations
Coloring Agents
Teratoma
Endodermal Sinus Tumor
Mucin-1
Staining and Labeling
Mediastinum
Receptor Protein-Tyrosine Kinases
Embryonic Stem Cells
Abdomen
germ-cell AP isoenzyme
Carcinogenesis
Transcription Factors
Central Nervous System
Sensitivity and Specificity

Keywords

  • AP-2γ
  • c-kit
  • D2-40
  • Extragonadal
  • Germ cell tumor
  • Mediastinum
  • OCT3/4
  • Pineal

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Iczkowski, K. A., Butler, S. L., Shanks, J. H., Hossain, D., Schall, A., Meiers, I., ... MacLennan, G. T. (2008). Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors. Human Pathology, 39(2), 275-281. https://doi.org/10.1016/j.humpath.2007.07.002

Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors. / Iczkowski, Kenneth A.; Butler, Samantha L.; Shanks, Jonathan H.; Hossain, Deloar; Schall, Albrecht; Meiers, Isabelle; Zhou, Ming; Torkko, Kathleen C.; Kim, Stacy J.; MacLennan, Gregory T.

In: Human Pathology, Vol. 39, No. 2, 01.02.2008, p. 275-281.

Research output: Contribution to journalArticle

Iczkowski, KA, Butler, SL, Shanks, JH, Hossain, D, Schall, A, Meiers, I, Zhou, M, Torkko, KC, Kim, SJ & MacLennan, GT 2008, 'Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors', Human Pathology, vol. 39, no. 2, pp. 275-281. https://doi.org/10.1016/j.humpath.2007.07.002
Iczkowski, Kenneth A. ; Butler, Samantha L. ; Shanks, Jonathan H. ; Hossain, Deloar ; Schall, Albrecht ; Meiers, Isabelle ; Zhou, Ming ; Torkko, Kathleen C. ; Kim, Stacy J. ; MacLennan, Gregory T. / Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors. In: Human Pathology. 2008 ; Vol. 39, No. 2. pp. 275-281.
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AU - Schall, Albrecht

AU - Meiers, Isabelle

AU - Zhou, Ming

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