Immunohistochemical markers of carcinoma in situ of the testis also expressed in normal infantile germ cells

Carcinoma in situ of the testis is an intratubular, pre‐invasive lesion preceding germ cell tumour. In adult men, carcinoma in situ cells differ in several aspects from normal germ cells. For example, placental‐like alkaline phosphatase and/or the epitopes for the monoclonal antibodies M2A, 43‐9F and TRA‐1–60 are not seen in normal germ cells, whereas their presence is considered a specific sign of carcinoma in situ. As it is known that placental‐like alkaline phosphatase and the epitope for TRA‐1–60 are expressed in normal fetal germ cells it is possible that the markers could appear in normal infantile germ cells in a period after birth before they lose their expression. In children, carcinoma in situ cells may be difficult to identify morphologically and the use of the markers could be of great value. However, little information is available on the expression of the markers of adult carcinoma in situ in normal infantile germ cells. We investigated gonads from 66 boys less than 15 years old who died suddenly. Their deaths were unrelated to testicular disease. Immunohistochemical staining with anti‐placental‐like alkaline phosphatase antibody and monoclonal antibodies TRA‐1–60 and 43–9F were performed. We found that these markers were expressed in some normal infantile germ cells until the age of 1 year. Therefore, these markers are not suitable for diagnosis of carcinoma in situ during the early postnatal period of life. Furthermore, our findings of placental‐like alkaline phosphatase and the epitope for TRA‐1–60 in normal germ cells before birth indicate that the markers of adult carcinoma in situ cells are of embryonic origin. This is in accordance with the hypothesis that carcinoma in situ cells are fetal germ cells malignantly transformed during fetal life, although re‐expression of the antigens could provide an alternative explanation.