Screening for intratubular germ cell neoplasia of the testis using OCT4 immunohistochemistry

Timothy D. Jones, Gregory T. MacLennan, Jose M. Bonnin, Mary F. Varsegi, Jean E. Blair, Liang Cheng

Research output: Contribution to journalArticle

18 Scopus citations


Specific populations of patients are at high risk for the development of germ cell neoplasia. OCT4 has been shown to be a sensitive and specific marker for intratubular germ cell neoplasia of the testis. Whether or not OCT4 immunohistochemistry is a clinically useful screening tool in patients at risk for developing malignant germ cell tumors is not currently known. We undertook immunohistochemical staining for OCT4 in a large series of patients who underwent testicular biopsy or orchiectomy for reasons other than for management of a testicular mass suspicious for malignancy (infertility, cryptorchidism, atrophic testicle, etc.). OCT4 nuclear staining was identified in germ cells in 6 of 157 patients, all of whom had clinical risk factors for the development of testicular germ cell tumors. Two of the 6 patients were under 1.5 years of age, making the significance of OCT4 positivity less certain in these cases. The remaining patients with OCT4-positive germ cells consisted of 3 adults and 1 7-year-old child. Intratubular germ cell neoplasia was identified by light microscopy in only 1 of the 6 OCT4-positive cases. OCT4 immunostaining was negative in all patients who presented with infertility and who had no additional germ cell tumor risk factors. OCT4 immunohistochemistry may be useful in identifying early forms of preinvasive germ cell neoplasia in patients with risk factors for the development of malignant testicular germ cell tumors. The low incidence of OCT4 positivity in the adult infertility patients argues against the routine use of OCT4 immunostains in testicular biopsies for infertility unless additional risk factors are present.

Original languageEnglish (US)
Pages (from-to)1427-1431
Number of pages5
JournalAmerican Journal of Surgical Pathology
Issue number11
StatePublished - Nov 1 2006


  • Cryptorchidism
  • Immunohistochemistry
  • Infertility
  • Intratubular germ cell neoplasia
  • Neoplasia
  • OCT3/4
  • OCT4
  • POU5F1
  • Screening
  • Testis

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

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