Histology of Testicular Biopsies Obtained for Experimental Fertility Preservation Protocol in Boys with Cancer.
Histology of Testicular Biopsies Obtained for Experimental Fertility Preservation Protocol in Boys with Cancer.
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DOI：
10.1016/j.juro.2015.04.117
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发表时间：
2015-11
期刊：
影响因子：
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通讯作者：
Kolon TF
中科院分区：
文献类型：
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作者：
Pietzak EJ 3rd;Tasian GE;Tasian SK;Brinster RL;Carlson C;Ginsberg JP;Kolon TF
睾丸组织冷冻保存及治疗后再植入对青春期前患有癌症的男孩具有生育力持续的潜力。我们提出了这种新方法的组织学和睾丸组织采购的可行性。我们对2008年至2011年期间符合实验研究方案的治疗相关性性腺毒性显著风险的男孩进行了一项前瞻性队列研究。在麻醉后进行开放性睾丸活检，以进行另一项治疗相关手术。一半的标本用于冷冻保存，另一半用于研究目的。对活检标本的半薄切片进行组织学特征评价，并与年龄调整的参考值进行比较。在2008年3月至2011年10月期间接受活检的34名男孩中，29名患有实体瘤，5名因良性疾病接受造血干细胞移植。其中，27例有足够的组织进行组织学分析。男孩的中位年龄为8.7岁（IQR=2.2 - 11.5岁）。所有儿童的每个小管中正常生殖细胞数量正常（81.5%）或增加（18.5%）。然而，18.5%（5/27）的男孩没有成年暗（Ad）精原细胞的证据，56%（9/16）的男孩活检没有初级精母细胞的证据，这将是他们的年龄标准。这些发现提示生殖细胞成熟异常。初步的组织学发现异常精子发生成熟的睾丸青春期前男孩与癌症值得进一步调查。
Cryopreservation of testicular tissue with subsequent re-implantation after therapy has fertility perseveration potential for pre-pubertal boys with childhood cancer. We present the histology and the feasibility of testicular tissue procurement for this novel approach. We performed a prospective cohort study of boys at significant risk for treatment-associated gonadotoxicity who were eligible for an experimental research protocol between 2008 and 2011. Open testicular biopsy was performed while they were anesthetized for another treatment related procedure. Half of the specimen was reserved for cryopreservation, while the other half was used for research purposes. Semi-thin sections of the biopsy specimens were evaluated for histological features and compared to age-adjusted reference values. Of the 34 boys who underwent biopsy between March 2008 and October 2011, 29 had solid tumors and 5 underwent hematopoietic stem cell transplantation for benign disease. Of these, 27 had adequate tissue for histologic analysis. The median age of the boys was 8.7 years (IQR=2.2 – 11.5 years). All children had either normal (81.5%) or increased (18.5%) numbers of normal germ cells per tubules for their age. However, 18.5% (5/27) of boys had no evidence of Adult dark (Ad) spermatogonia, and 56% (9/16) of boys had no evidence of primary spermatocytes on biopsy, that would be expected for their age norms. These findings are suggestive of abnormal germ cell maturation. The preliminary histologic findings of abnormal spermatogenesis maturation in testes of pre-pubertal boys with cancer warrants further investigation.