THE PREPUBERTAL TESTIS (PRENATAL AND POSTNATAL) - ITS RELATIONSHIP TOINTRATUBULAR GERM-CELL NEOPLASIA - A COMBINED PEDIATRIC-ONCOLOGY-GROUP AND CHILDRENS-CANCER-STUDY-GROUP

Seminiferous tubules adjacent to germ cell tumors (GCT) in prepubertal boys frequently contain increased germ cells with abundant, clear cyt oplasm. These cells are placental alkaline phosphatase (FLAP) negative and are usually not considered to represent intratubular germ cell ne oplasia (ITGCN). A recent case report found p53 and proliferating cell nuclear antigen (PCNA) positivity in such cells and equated these PLA P-negative cells with ITGCN. Because the proto-oncogene c-kit is also a marker of ITGCN, immunohistochemical tests for c-Kit and FLAP were p erformed on 28 testes adjacent to prepubertal GCT in children aged 2 t o 45 months. Additional slides from testes not associated with GCT fro m 18 preterm infants and children ages 19 weeks to 7 years were also t ested. An adult testis with seminoma and ITGCN served as a positive co ntrol. PCNA, FLAP, and p53 were tested on available slides. No intratu bular germ cells adjacent to GCT in prepubertal children were positive for FLAP or c-kit; five of seven were positive for PCNA; p53 was pres ent in the two examined. These results indicate that germ cells adjace nt to infantile GCT are proliferative but not neoplastic and offer add itional evidence that intratubular germ cells and GCT in prepubertal b oys are different from those of adolescents and adults. Copyright (C) 1997 by W.B. Saunders Company.