睾丸癌47例诊治分析

Diagnosis of testicular cancer： review of 47 cases

目的通过回顾性分析47例睾丸癌病例，提高睾丸癌的诊断水平。方法回顾性分析47例睾丸癌病例的症状，体征，影像学检查，肿瘤标志物和病理检查结果。结果所有患者均可扪及睾丸内肿块。阴囊超声是诊断睾丸肿瘤的有效手段，敏感度达到90％以上。CT对于腹膜后淋巴结评价具有很高的敏感性，但是同时具有一定的假阳性率。肿瘤标志物，尤其是甲胎蛋白对于睾丸肿瘤的诊断和预后有显著的意义。病理诊断提示：精原细胞瘤27例，胚胎性癌7例，畸胎瘤6例，淋巴瘤3例，精母细胞瘤1例，横纹肌肉瘤1例。结论患者自我检查对于早期诊断非常有帮助。超声检查和CT分别在诊断和分期上有不可取代的作用。肿瘤标志物在睾丸癌诊断和预后中扮演了关键的角色，应该被列为常规的检查项目。

Objective To improve the diagnostic level of testicular cancer by a retrospective review of 47 cases. Methods The symptoms, signs, imaging studies, tumour markers and histological diagnoses of 47 cases were reviewed. Results The mass in testes was palpated in all patients. As a useful tool in the diagnosis of testicular cancer, scrotal ultrasonography had a detecting sensitivity over 90%. Though sensitive to retroperitoneal lymph nodes, CT had a certain level of false positive rate. Tumor markers, especially AFP, were significantly useful in the diagnosis and prognosis of testicular cancer. Histological examination showed 27 cases of seminoma, 7 cases of embyonal carcinoma, 6 cases of teratoma, 3 cases of lymphoma, 1 case of spermatocytic seminoma and 1 case of sarcoma. Conclusion Patient self-examination is extremely helpful for an earlier diagnosis. Ultrasonography and CT are invaluable in the diagnosis and staging of testicular cancer. Playing key roles in the diagnosis and prognosis of testicular cancer, tumour markers should be routinely examined.