Semen was analysed from 12 patients with known testicular cancer and from a number of control groups, including men with other types of cancers and infertility problems, and a group of apparently healthy young men attending the hospital for other projects.
Dr Hoei-Hansen said: "When we were evaluating the first series of semen samples we detected AP-2y positive cells in a sample from one of the healthy controls. He was a 23-year-old man who was having a routine semen analysis because he and his partner had been trying unsuccessfully for 18 months to have a baby." Apart from the AP-2y positive cells there were no other indications of testicular cancer, but further clinical evaluation, including a biopsy, revealed CIS in his left testicle.
Doctors advised the patient to have surgery to remove the testicle with the CIS, freezing semen samples beforehand. No chemotherapy or radiotherapy was required. In a happy ending to the story, the patient and his partner are awaiting the birth of their first child, which was conceived naturally, without assisted reproduction.
Professor Niels E. Skakkebk, head of the University Department of Growth and Reproduction, at the Rigshospitalet, said: "To our knowledge, this is the first report of the diagnosis of testicular cancer at the pre-invasive CIS stage in a semen sample from a young patient with suspected infertility, who if not for the inclusion in our study of AP-2y would most probably have been diagnosed much later, perhaps only after an overt tumour had developed. This is a new, simple method of screening, using AP-2y as a novel marker for CIS. The value of this method for diagnostic use in the clinic requires further, careful validation in a large series of patients and controls, but the preliminary results are promising."
At present, the preparation, staining and analysis of a semen sample takes just over a day in total, but
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Contact: Emma Mason
wordmason@mac.com
44-1-376-563-090
European Society for Human Reproduction and Embryology
2-Mar-2005