Antisperm Antibody in Testicular Cancer Patients

本文检测了47例生殖细胞癌、17例睾丸精原细胞瘤、26例非精原细胞瘤和4例性腺外非精原细胞瘤患者血清中抗精子抗体水平。用间接精子固定试验(Isojima‘s法)和间接酶联免疫吸附试验(ELISA)检测抗精子抗体的存在。精子制动试验无1例抗精子抗体阳性，ELISA12例(25.5%)抗精子抗体滴度>1：32。睾丸精原细胞瘤阳性率为35.5%，非精原细胞瘤阳性率为15.4%，性腺外生殖细胞瘤阳性率为50%。抗精子抗体阳性率与肿瘤组织学类型及疾病分期无关。本病患者血清与治疗成功患者血清抗体阳性率差异无统计学意义。治疗3年后，部分患者出现抗体阳性，检测血清质量和血清FSH水平，探讨抗精子抗体对睾丸功能影响。抗体阳性患者的精液质量不受影响。抗体阳性患者血清FSH水平升高的发生率并不高于抗体阴性患者。结论：用ELISA法检测睾丸癌患者血清中的抗精子抗体与肿瘤组织学、疾病分期、疾病治疗及生育状况无关。抗精子抗体不能作为睾丸癌的肿瘤标志物。

The level of antisperm antibodies was evaluated in the serum of 47 patients with germ cell cancer ; 17 patients with testicular seminomas, 26 with non-seminomatous testicular germ cell tumors and 4 with extragonadal non-seminomatous germ cell tumors. The presence of antisperm antibodies was assessed using the indirect sperm immobilization test (Isojima's mothod) and the indirect Enzyme-Linked ImmunoSorbent Assay (ELISA). No patients showed a positive antisperm antibody by the sperm immobilization test, while 12 patients (25.5%) showed a positive serum titer of antisperm antibodies more than 1 : 32 by ELISA. The antibody was positive in 35.5% of the patients with testicular seminomas, 15.4% of those with non-seminomatous testicular tumors, and 50% of those with extragonadal germ cell tumors. There was no relation between the incidence of positive antisperm antibodies by ELISA and the tumor histology or the stage of the disease. The incidence of the antibody was not statistically different between the serum from the patients with the disease and those from the patients after the successful treatment. Several patients showed positive antibodies more than 3 years after treatment.Semen quality and serum FSH levels were studied to investigate the effect of the antisperm antibody on the testicular function. Semen quality was not deterirated in the antibody positive patients. Incidence of the elevated serum FSH levels in the antibody positive patients was not higher than that in the antibody negative patients.In conclusion, antisperm antibodies in the testicular cancer patients assessed using ELISA were not related to either tumor histology, stage of the disease, treatment of the disease, or the condition of the fertility. Antisperm antibodies were not useful as a tumor marker of testicular cancer.