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Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers: IV: Current and Future Utilization of Molecular-Genetic Tests for Testicular Germ Cell Tumors.

ABSTRACT: The International Society of Urological Pathology (ISUP) organized a Consultation Conference in March 2019 dealing with applications of molecular pathology in Urogenital Pathology, including testicular tumors (with a focus on germ cell tumors [GCTs]), preceded by a survey among its members to get insight into current practices in testicular germ cell tumor (TGCT) diagnostics and adoption of the ISUP immunohistochemical guidelines published in 2014. On the basis of the premeeting survey, the most commonly used immunomarker panel includes OCT3/4, placental alkaline phosphate, D2-40, SALL4, CD117, and CD30 for GCTs and the documentation of germ cell neoplasia in situ (GCNIS). Molecular testing, specifically 12p copy gain, is informative to distinguish non-GCNIS versus GCNIS related GCTs, and establishing germ cell origin of tumors both in the context of primary and metastatic lesions. Other molecular methodologies currently available but not widely utilized for TGCTs include genome-wide and targeted approaches for specific genetic anomalies, P53 mutations, genomic MDM2 amplification, and detection of the p53 inactivating miR-371a-3p. The latter also holds promise as a serum marker for malignant TGCTs. This manuscript provides an update on the classification of TGCTs, and describes the current and future role of molecular-genetic testing. The following recommendations are made: (1) Presence of GCNIS should be documented in all cases along with extent of spermatogenesis; (2) Immunohistochemical staining is optional in the following scenarios: identification of GCNIS, distinguishing embryonal carcinoma from seminoma, confirming presence of yolk sac tumor and/or choriocarcinoma, and differentiating spermatocytic tumor from potential mimics; (3) Detection of gain of the short arm of chromosome 12 is diagnostic to differentiate between non-GCNIS versus GCNIS related GCTs and supportive to the germ cell origin of both primary and metastatic tumors.

SUBMITTER: Looijenga LHJ

PROVIDER: S-EPMC7289140 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers: IV: Current and Future Utilization of Molecular-Genetic Tests for Testicular Germ Cell Tumors.

Looijenga Leendert H J LHJ Van der Kwast Theodorus H TH Grignon David D Egevad Lars L Kristiansen Glen G Kao Chia-Sui CS Idrees Muhammad T MT

The American journal of surgical pathology 20200701 7

The International Society of Urological Pathology (ISUP) organized a Consultation Conference in March 2019 dealing with applications of molecular pathology in Urogenital Pathology, including testicular tumors (with a focus on germ cell tumors [GCTs]), preceded by a survey among its members to get insight into current practices in testicular germ cell tumor (TGCT) diagnostics and adoption of the ISUP immunohistochemical guidelines published in 2014. On the basis of the premeeting survey, the most ...[more]

PMID: 32205480

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Project description:BACKGROUND: Current resuscitation guidelines recommend 3:1 Compression:Ventilation (C:V) ratio, however the most effective C:V ratio in newborns remains controversial. We recently demonstrate that if chest compressions (CC) are superimposed by sustained inflations (SI) return of spontaneous circulation (ROSC) and mortality are improved in asphyxiated newborn piglets when compared to standard coordinated 3:1 resuscitation. However, this has not been studied in newborns. OBJECTIVES: To determine if CC superimposed with SI impacts ROSC in infants <33 weeks with bradycardia or asystole compared to coordinated 3:1 C:V resuscitation. DESIGN/METHODS: In a pilot study, infants born <33 weeks gestational age with an heart rate <60/min or asystole were randomized to receive either “3:1 C:V” or “SS+CC”. Infants randomized to 3:1 received coordinated CC and ventilation according to the current resuscitation guidelines. Infants randomized to “SI+CC” received uninterrupted CC at a rate of 90/min superimposed by a SI of 30 sec. The default settings for airway pressures were peak inflation pressure of 24 cm H2O and a positive end expiratory pressure of 6 cm H2O. The primary outcome was duration of CC to achieve ROSC. Deferral of consent was approved by the institutional ethics committee. The trial was registered at ClinicalTrials.gov: NCT02083705. RESULTS: Five infants were randomized to each group; the mean (range) gestational age was 25 (24–27) weeks vs. 26 (23–28) weeks in the in the SI+CC and 3:1 group (P=0.433), respectively. Mean (SD) birth weight in the SI+CC group was 797 (208) g vs. 808 (182) g in the 3:1 group, (P=0.465) respectively. Mean (SD) ROSC was significantly decreased in the SI+CC group with 31 (8) sec vs. 138 (72) sec in the 3:1 group (P=0.011). One infant in each group died and only one infant in the 3:1 group received epinephrine. One infant in the SI+CC group and three in the 3:1 had intracranial hemorrhage grade 3 or greater. Three infants in the SI+CC group had necrotizing enterocolitis vs. one infant in the 3:1 group (P=0.197). CONCLUSION: Preterm infants <33 weeks had significant shorter ROSC when CC were superimposed by SI compared to using 3:1.

Dataset Information

Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers: IV: Current and Future Utilization of Molecular-Genetic Tests for Testicular Germ Cell Tumors.

Publications

Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers: IV: Current and Future Utilization of Molecular-Genetic Tests for Testicular Germ Cell Tumors.

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