性别确认手术中睾丸切除标本的临床病理分析及数字病理评价。

IF 2.9 4区医学 Q2 PATHOLOGY

Pathology, research and practice Pub Date : 2025-03-13 DOI:10.1016/j.prp.2025.155914

Ivan De La Riva-Morales , Alcino Gama , Ruoji Zhou , Bonnie Choy , Bogdan Isaila , Behtash G. Nezami , Robert Brannigan , Diana Bowen , Ximing Yang

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引用次数: 0

摘要

近年来，针对变性者和性别多元化者（TGD）的性别确认疗法越来越多。TGD患者通常会接受各种形式的激素替代疗法（HRT），然后进行双侧睾丸切除术。我们旨在描述这些标本的组织学和生化改变特征。2018-2023 年间，63 名 TGD 患者接受了确认性别的睾丸切除术。发现了萎缩性变化、精子发生减少、平均小管直径减小和基底膜增厚，以及成熟停滞和精子发生。一部分标本（n = 81，64.8%）显示生精细胞核肿大，细胞学不典型性模仿生精细胞原位癌，为了将这一发现与真正的肿瘤过程区分开来，我们进行了详细的数字病理学和免疫组化检查。据我们所知，这是规模最大的单中心睾丸切除术标本群。

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Clinicopathologic analysis and digital pathology evaluation of orchiectomy specimens in gender-affirmation surgery

Gender-affirmation therapies for transgender and gender diverse (TGD) individuals has been increasing in numbers in recent years. TGD patients usually undergo various forms of hormonal replacement therapy (HRT) followed by bilateral orchiectomy. We aimed to characterize the histological and biochemical alterations in these specimens. From 2018–2023, 63 TGD individuals undergone gender-affirming orchiectomy. Atrophic changes, decreased spermatogenesis, and reduced mean tubule diameter with basement membrane thickening, as well as maturation arrest and aspermatogenesis were identified. A subset of specimens (n = 81, 64.8 %) showed germ cell nucleomegaly with cytological atypia mimicking germ cell neoplasia in situ, and detailed digital pathology and immunohistochemical were performed to distinguish this finding from true neoplastic processes. To our knowledge, this is the largest single-center cohort of gender-affirming orchiectomy specimens.

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来源期刊

Pathology, research and practice 医学-病理学

CiteScore

5.00

自引率

3.60%

发文量

405

审稿时长

24 days

期刊介绍： Pathology, Research and Practice provides accessible coverage of the most recent developments across the entire field of pathology: Reviews focus on recent progress in pathology, while Comments look at interesting current problems and at hypotheses for future developments in pathology. Original Papers present novel findings on all aspects of general, anatomic and molecular pathology. Rapid Communications inform readers on preliminary findings that may be relevant for further studies and need to be communicated quickly. Teaching Cases look at new aspects or special diagnostic problems of diseases and at case reports relevant for the pathologist''s practice.