The predictive value of testicular ultrasound abnormalities for carcinoma in situ of the testis in men at risk for testicular cancer

PURPOSE: To elucidate the biologic association between germ cell neoplasia and testicular dysfunction, through investigation of Leydig cell function and semen quality in men with carcinoma-in-situ (CIS) of the testis. PATIENTS AND METHODS: We examined two groups of men, unilaterally orchidectomized for testicular cancer. Biopsy of the contralateral testis had showed CIS in a group of 24 patients and no evidence of CIS in the other group of 30 patients. Semen quality and serum levels of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were compared in these two groups of men after orchidectomy but before further treatment for testicular cancer. RESULTS: Significantly higher LH levels (median, 8.1 IU/L v 4.8 IU/L; P < .001) and generally lower testosterone levels (median, 12.5 nmol/L v 15.5 nmol/L; P = .13) were found in the CIS group. The proportion of patients with Leydig cell dysfunction was higher in the group of patients with CIS (11 of 24) than in the group of patients without (two of 30) (P = .01). Sperm concentration and total sperm count were significantly lower (P < .001) in patients with CIS (median, 0.03 × 106/mL and 0.10 × 106, respectively) than in patients without (median, 9.1 × 106/mL and 32 × 106, respectively), whereas the levels of FSH were significantly higher (P < .001) in the former group of men (median, 19.6 IU/L v 9.0 IU/L). CONCLUSION: Not only spermatogenesis but also Leydig cell function is impaired in testes with CIS. This impairment could be due to common factors in the pathogenesis of germ cell neoplasm and testicular dysfunction. Alternatively, CIS cells may have a negative impact on Leydig cell function.

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Fatherhood in Testicular Cancer Patients with Carcinoma in situ in the Contralateral Testicle

European Urology ◽

10.1159/000020369 ◽

2000 ◽

Vol 38 (6) ◽

pp. 725-727 ◽

Cited By ~ 3

Author(s):

K.D. Jacobsen ◽

S.D. Fosså

Keyword(s):

Testicular Cancer ◽

Cancer Patients ◽

Carcinoma In Situ

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Screening for carcinoma in situ of the contralateral testis in patients with germinal testicular cancer.

BMJ ◽

10.1136/bmj.285.6356.1683 ◽

1982 ◽

Vol 285 (6356) ◽

pp. 1683-1686 ◽

Cited By ~ 115

Author(s):

J G Berthelsen ◽

N E Skakkebaek ◽

H von der Maase ◽

B L Sorensen ◽

P Mogensen

Keyword(s):

Testicular Cancer ◽

Carcinoma In Situ ◽

Contralateral Testis

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Results of Two Years Expenience with Fluorescence Bronchoscopy in Detection of Preinvasive Bronchial Neoplasia

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.5.77 ◽

1999 ◽

Vol 5 (2) ◽

pp. 77-84 ◽

Cited By ~ 31

Author(s):

Ben J. W. Venmans ◽

Ton J. M. Van Boxem ◽

Egbert F. Smit ◽

Pieter E. Postmus ◽

Tom G. Sutedja

Keyword(s):

At Risk ◽

Patient Group ◽

Carcinoma In Situ ◽

Separate Analysis ◽

Predictive Values ◽

Neoplastic Lesions ◽

Preinvasive Lesions ◽

Bronchial Biopsies

The aim of the study was to determine whether use of fluorescence bronchoscopy improves the detection of preinvasive neoplastic bronchial lesions. The data of all patients who underwent fluorescence bronchoscopy and in whom bronchial biopsies were taken, were analyzed. Most patients were at risk for preinvasive lesions. A total of 174 bronchoscopies were performed in 95 patients. Of the 681 representative biopsies, 31 were found to be moderate dysplastic, 39 were found to be severe dysplastic and 9 exhibited carcinoma in situ. These 79 preinvasive lesions were found in 34 patients. The respective results of fluorescence bronchoscopy in addition to conventional bronchoscopy and of conventional bronchoscopy alone for detection of preinvasive lesions were: sensitivity 85% (67/79) and 59% (47/79); specificity 60% (351/581) and 85% (493/581); positive predictive values of 23% (67/297) and 35% (47/135); negative predictive values of 97% (351/363) and 94% (493/525). A separate analysis of only the first bronchoscopy of each patient showed similar results. Results of fluoresence bronchoscopy were better in the second part of the patient group. We conclude that after a learning period fluorescence bronchoscopy can increase the yield of finding preinvasive neoplastic lesions when used in addition to conventional bronchoscopy.

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Revisit the practice of lymph node biopsy in patients diagnosed as ductal carcinoma in situ before operation: a retrospective analysis of 682 cases and evaluation of the role of breast MRI

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02336-w ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Hung-Wen Lai ◽

Yi-Lin Chang ◽

Shou-Tung Chen ◽

Yu-Jun Chang ◽

Wen-Pei Wu ◽

...

Keyword(s):

Lymph Node ◽

Ductal Carcinoma In Situ ◽

Tumor Size ◽

Predictive Value ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Breast Mri ◽

Invasive Cancer ◽

Node Negative

Abstract Background The optimal axillary lymph node (ALN) management strategy in patients diagnosed with ductal carcinoma in situ (DCIS) preoperatively remains controversial. The value of breast magnetic resonance imaging (MRI) to predict ALN metastasis pre-operative DCIS patients was evaluated. Methods Patients with primary DCIS with or without pre-operative breast MRI evaluation and underwent breast surgery were recruited from single institution. The value of breast MRI for ALN evaluation, predictors of breast and ALN surgeries, upgrade from DCIS to invasive cancer, and ALN metastasis were analyzed. Results A total of 682 cases with pre-operative diagnosis of DCIS were enrolled in current study. The rate of upgrade to invasive cancer were found in 34.2% of specimen, and this upgrade rate is 23% for patients who received breast conserving surgery and 40.7% for mastectomy (p < 0.01). Large pre-operative imaging tumor size and post-operative invasive component were risk factors to ALN metastasis. Breast MRI had 53.8% sensitivity, 77.8% specificity, 14.9% positive predictive value, 95.9% negative predictive value (NPV), and 76.2% accuracy to predict ALN metastasis in pre-OP DCIS patients. In MRI node-negative breast cancer patients with MRI tumor size < 3 cm, the NPV was 96.4%, and all these false-negative cases were N1. Pre-OP diagnosed DCIS patients with MRI tumor size < 3 cm and node negative suitable for BCS could safely omit SLNB if whole breast radiotherapy is to be performed. Conclusion Breast MRI had high NPV to predict ALN metastasis in pre-OP DCIS patients, which is useful and could be provided as shared decision-making reference.

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