{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:23:16Z","timestamp":1790461396203,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,2,16]],"date-time":"2011-02-16T00:00:00Z","timestamp":1297814400000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:p>Stoop H, Kirkels W, Dohle G R, Gillis A J M, den Bakker M A, Biermann K, Oosterhuis W &amp; Looijenga L H J\u2028(2011) <jats:italic>Histopathology<\/jats:italic><jats:bold>58<\/jats:bold>, 440\u2013446\u2028<jats:bold>Diagnosis of testicular carcinoma <jats:italic>in situ<\/jats:italic>\u2018(intratubular and microinvasive)\u2019 seminoma and embryonal carcinoma using direct enzymatic alkaline phosphatase reactivity on frozen histological sections<\/jats:bold><\/jats:p><jats:p><jats:bold>Aims:\u2002<\/jats:bold> Testis\u2010sparing surgery might benefit quality of life, but can only be applied with histological examination for the presence of invasive germ cell tumour components, and the precursor carcinoma <jats:italic>in situ<\/jats:italic> (CIS). Currently, diagnosis is based on paraffin\u2010embedded tissue, therefore a delay in further surgery is mainly unavoidable. The aim was to develop an intraoperative assessment technique using alkaline phosphatase as a marker.<\/jats:p><jats:p><jats:bold>Methods and results:\u2002<\/jats:bold> A total of 4093 snap\u2010frozen samples and matched paraffin\u2010embedded tissue of 1500 patients were included. Besides standard haematoxylin and eosin (H&amp;E) staining, the direct enzymatic alkaline phosphatase reactivity (dAP) test (duration 15\u2003min) was applied on frozen sections, while H&amp;E and immunohistochemistry for detection of OCT3\/4, \u03b1\u2010fetoprotein, human chorionic gonadotrophin (hCG) and cytokeratin was performed on the paraffin\u2010embedded slides. Endothelial cells served as control for the dAP test. Positive staining was found in all CIS (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>965), seminoma (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>1035) and embryonal carcinoma (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>584), either intratubular, microinvasive or invasive. Differentiated non\u2010seminomas (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>1238) showed variable staining. No staining was identified in spermatocytic seminomas (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>5), testicular lymphomas (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>42), testicular rhabdomyosarcomas (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>7), Leydig cell tumours (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>31), Sertoli\u2010cell\u2010only nodules (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>4), (epi) dermoid cyst (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>16), normal testicular parenchyma (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>116), testicular torsion (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>32) and inflammation of the epididymis (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>19). The dAP test results matched H&amp;E\u2010stained parallel sections, as well paraffin\u2010embedded tissue analysis, including immunohistochemistry.<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> The dAP test is an informative, reproducible and easy tool to diagnose CIS, (intratubular and microinvasive) seminoma and embryonal carcinoma on frozen tissue sections, being of great value in the context of sparing surgery.<\/jats:p>","DOI":"10.1111\/j.1365-2559.2011.03767.x","type":"journal-article","created":{"date-parts":[[2011,2,16]],"date-time":"2011-02-16T18:14:22Z","timestamp":1297880062000},"page":"440-446","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Diagnosis of testicular carcinoma <i>in situ<\/i>\u2018(intratubular and microinvasive)\u2019 seminoma and embryonal carcinoma using direct enzymatic alkaline phosphatase reactivity on frozen histological 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