Abstract
Objective To explore the clinicopathological characteristics and prognosis of primary testicular malignant tumor,in order to improve the understanding,diagnosis and treatment of the disease. Methods The clinical data of 67 patients with primary testicular malignant tumor received in our hospital from February 2010 to February 2015 were analyzed retrospectively and their clinical features,pathological characteristics,diagnosis,treatment as well as prognosis were summarized and analyzed. Re-sults The age of the patients ranged from 8 months to 84 years old,39. 0 years for average,29 cases occurring on the left side and 38 cases occurring on the right side,with 1 case complicated with bladder carcinoma. 15 cases(22. 4%) had a history of cryp-torchidism,of which 2 cases were bilateral. The most common pathological type of cryptorchidism tumor was seminoma,where there was 11 cases making up for 73. 3%. As for serum tumor marker such as AFP,HCG and LDH,14 cases(42. 4%)of seminoma and 22 cases(91. 7%)of non-seminoma were observed an elevation. There were 57 cases of germinoma(85%),including 33 cases of seminoma(including 1 case of seminoma accompanied by syncytiotrophoblasts and 1 case of spermatocytic seminoma with sarcoma component)and 24 cases(35. 8%)of non-seminoma,which consisted of 5 cases of embryonal carcinoma,2 cases of yolk sac tumor and 17 cases of mixed germ cell tumor. Additionally,there was 1 case(1. 5%)of Leydig cell tumor,6 cases(9. 0%)of lymphoma (all non-Hodgkin lymphoma and all diffuse large B cell lymphoma)and 3 cases(4. 5%)of sarcoma(1 case of liposarcoma,1 case of embryonic rhabdomyosarcoma and 1 case of synovial sarcoma). Among the 33 cases of seminoma,24 cases were stagedⅠ,inclu-ding 16 cases of stageⅠa and 8 cases of stageⅠs,7 cases were stagedⅡ,including 1 case of stageⅡa,2 cases of stageⅡb and 4 cases of stageⅡc,and 2 cases were stagedⅢb. Among the 34 cases of other types of tumors,21 cases were stagedⅠ,including 9 cases of stage Ⅰa,2 cases of stageⅠb and 10 cases of stageⅠs,3 cases were stagedⅡ,including 1 case of stageⅡa,1 case of stage Ⅱb and 1 case of stageⅡc,10 cases were stagedⅢ,2 cases of stageⅢa,6 cases of stageⅢb and 2 cases of stageⅢc. Patients stagedⅠaccounted for the highest proportion as 45 cases(67. 2%),while 10 cases were stagedⅡ(14. 9%)and 12 cases were staged Ⅲ(17. 9%). There was no statistically significant difference between stage Ⅱ proportion and stage Ⅲ proportion. As for treatment,5 cases of seminoma underwent simple radical orchiectomy(RO),20 cases of seminoma underwent RO plus chemo-therapy,3 cases of seminoma underwent RO plus radiotherapy( including 1 case undergoing additional retroperitoneal lymph node dissection,RPLND)and 5 cases of seminoma underwent RO plus radiotherapy plus chemotherapy. For other types of tumors,10 ca-ses underwent RO(including 1 case undergoing additional RPLND),1 case underwent simple chemotherapy,20 cases underwent RO plus chemotherapy(including 2 cases undergoing additional RPLND)and 3 cases underwent RO plus radiotherapy plus chemo-therapy(including 1 case undergoing additional RPLND). Postoperative follow-up ranged from 2 to 64 months,with an average of 48. 8 months. 48 cases showed no recurrence or metastasis,and 19 cases finally died,including 4 cases of seminoma and 15 cases of other types of tumors. The average survival time of patients with seminoma was 58. 3 months,while that of patients with other types of tumors was 34. 8 months,the difference of survival time between the two groups being statistically significant(P＜0. 05). Conclusion The overall prognosis of testicular tumors is favorable,which is closely related to clinical stages and pathological types. The prognosis of seminoma is significantly better than that of other types of testicular tumors. Early diagnosis and comprehen-sive individualized treatment are of great significance to improve the prognosis of testicular tumors.关键词
睾丸肿瘤/治疗/预后/回顾性分析Key words
testicular tumors/treatment/prognosis/retrospective analysis分类
医药卫生
