Clinical and Histopathological Significance of Immunohistochemical β‐Human Chorionic Gonadotropin (β‐
hCG
) Expression in Mononuclear Seminoma Cells
Göktuğ Kalender, Muhammet Demirbilek, Kadir Can Şahin, Emre Akkuş, Hamdi Özkara, Zeyneb Ali Yılmaz, Bülent Önal, İclal Gürses ABSTRACT
Objectives
To examine the morphological features of cases with immunohistochemical (IHC) expression of beta‐human chorionic gonadotropin (β‐hCG) in mononuclear seminoma cells (MSC) and to investigate the histopathological and clinical significance of this expression pattern.
Methods
A total of 76 patients with pure seminoma (without syncytiotrophoblastic giant cells) and at least 1 year of follow‐up were included in the study. IHC staining for β‐hCG and CD117 (c‐KIT) was retrospectively performed. The β‐hCG and CD117 expression patterns in MSC were scored as negative (0%), focal (0%–5%), patchy (6%–50%), diffusely positive (> 50%). The patients were grouped into clinical stage (CS) I and CS II–III, and their clinical and histopathological parameters were compared.
Results
The median age of the 76 patients was 34 years (range, 28–42), and the median follow‐up duration was 59 months (range, 39–79). 61 patients (80.3%) were classified as CS I and 15 patients (19.7%) as CS II–III. In multivariable analysis, the presence of IHC β‐hCG expression was associated with CS (OR = 2.238, 95% CI: 1.092–4.751, p = 0.028). In CS I cases, a patchy/diffuse expression pattern was significantly correlated with rete testis invasion (RTI) ( p = 0.001). An inverse relationship was observed between β‐hCG expression and CD117 expression in tumor cells ( p = 0.002).
Conclusions
β‐hCG expression in MSC is associated with CS and, in CS I patients, the expression pattern is associated with RTI. As MSC may exhibit anaplastic/atypical morphological features, comprehensive tumor sampling and β‐hCG immunohistochemical staining may be valuable.