睾丸恶性肿瘤的临床治疗分析——附26例报告

Analysis of clinical treatment for malignant tumor of testis

目的:研究睾丸恶性肿瘤的治疗原则、方法的选择以及瘤标监测的临床意义。方法:对26例不同类型的睾丸恶性肿瘤应首选行根治性睾丸切除术,术后并配合进行化疗或放疗。术后定期检测β-hCG和AFP以观察肿瘤是否有复发趋势。结果:本组26例中,25例获得随访（96.2％）。12例T1期11例获得随访,未发现肿瘤复发和转移。T2～T4期13例均获得随访,经过化疗1～6疗程,放疗2000cGY以上,完全缓解8例（CR为61.5％）,部分缓解5例（PR为38.5％）。术前β-hCG升高者6例,AFP升高者1例,治疗后β-hCG和AFP均下降至正常（其中4例为胚胎癌）。另有1例T1期精原细胞瘤在治疗过程中β-hCG正常,而在随访期中升高,经2个疗程化疗后β-hCG下降至正常。结论:隐睾症是睾丸恶性肿瘤的常见病因之一,本组占30.8％,对隐睾患儿应尽早手术固定。睾丸肿瘤手术应常规行根治性睾丸切除术。

Objective: To study the principle of treatment and choice of method in patient with malignant tumor of testis, and the clinical significance of tumor marker detection. Methods: 26 cases of malignant tumor of testis were first treated by radical orchiectomy, combined with chemotherapy or radiotherapy after operation. β-hCG and AFP were detected regularly to observe the tumor recurrence. Results: Of the 26 cases , 25 were followed-up (96.2%) . 11 cases of T1 phase were not found with tumor recurrence and metastasis, and 13 cases of T2～T4 were found that 8 cases were CR (61.5% ), 5 cases PR (35.8% ) after 1～6 courses of chemotherapy and more than 2000 cGY radiotherapy. 6 cases were found with high β-hCG and 1 with high AFP before operation, and they all became normal levels of β-hCG and AFP (incluching 4 cases of embryonal carcinoma) Conclusion: Cryptorchism is one of common reasons for malignant tumor of teatis, with the incidence of 30.8% at this material. Early operation and fixation should be done for the patients with cryptorchism, and radical orchiectomy be done for the patients with malignant tumor of testis.