ArticleThe Journal of clinical endocrinology and metabolism2026
Testis Molecular Pathways in CAIS Unveil Testosterone/Estradiol on Germ Cell Tumor Risk in Non-Obstructive Azoospermia.
Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Testis Molecular Pathways in CAIS Unveil Testosterone/Estradiol on Germ Cell Tumor Risk in Non-Obstructive Azoospermia.The Journal of clinical endocrinology and metabolism · 2026Article
- Integrative Transcriptomic Analysis and Preliminary Peripheral Blood Evaluation IdentifyInternational journal of general medicine · 2026Article
- Complete androgen insensitivity syndrome with cryptorchid sertoli cell tumor: a case report and literature review.Frontiers in medicine · 2026Article
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Authors and funding
15 authors.
Funding
Abstract
contextNon-obstructive azoospermia (NOA) is the most severe form of male infertility, affecting 1% of all men, with a clinical picture characterized by no sperm production, hyalinization of the basal membrane of the seminiferous tubules, primary hypogonadism, and earlier onset of age-related comorbidities compared with fertile men. NOA is also characterized by etiologic heterogeneity and the non-genetic form has higher incidence of testicular germ cell cancer (TGCC) compared to the forms with genetic abnormalities.
objectiveWe aimed to establish molecular pathways in the testicular somatic cells that are either shared or specific for non-genetic and genetic forms of NOA, such as complete androgen insensitivity syndrome (CAIS) and Klinefelter syndrome (KS).
methodsWe performed single-cell RNA sequencing of the testicular somatic cells of an individual with CAIS, and data integration with published scRNA-seq datasets of testis with normal spermatogenesis, NOA, KS, and germinal testicular cancer. Detailed clinical data of the CAIS patient, testosterone and estradiol levels in age-matched men (120 fertile, 155 infertile, 116 NOA, 18 KS, and 343 with TGCC) were analyzed.
resultsIn all conditions, Leydig cells are immature and senescent, but those of NOA associated with primary hypogonadism depict the highest expression of transcripts associated with the seminoma microenvironment, including estrogen-responsive genes. An oncological transcriptional signature in the Leydig cells has been confirmed at the systemic levels by showing a prognostic role of the decreasing testosterone/estradiol ratio for TGCC in men with non-genetic NOA.
conclusionThis study offers molecular insights into the prediction of TGCC in persons with NOA and eligibility for the use of aromatase inhibitors.
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