睾丸肿瘤61例临床与病理特征分析

Clinicopathological characteristics of testicular tumors:a single-center experience of 61 cases

目的探讨睾丸肿瘤发病率、临床及病理特征,分析常见恶性肿瘤的预后,结合文献为临床诊疗提供更多参考依据。方法收集惠州市中心人民医院2008-2019年间经病理确诊的61例睾丸肿瘤患者的临床诊治资料,包括年龄、发病部位、肿瘤大小、治疗经过及预后等,对其进行统计分析。结果61例患者年龄5个月~88岁,中位年龄35.5岁;病理学类型包括精原细胞瘤18例(29.5%),非精原细胞瘤25例(41.0%),淋巴造血系统肿瘤16例(26.2%),转移癌2例(3.3%);精原细胞瘤患者的中位年龄37岁,肿瘤平均最大径6 cm,均累及单侧睾丸,6例患者有隐睾病史,病理类型包括经典型及间变型,中位随访时间36.5个月,获得随访资料的14例患者均存活,总体预后佳;淋巴瘤患者的中位年龄64岁,肿瘤平均最大径5.7 cm,有4例累及双侧睾丸,中位随访时间35.5个月,获得随访资料的11例患者中4例死亡,总体预后不良;畸胎瘤患者的中位年龄15岁。结论精原细胞瘤、淋巴瘤、畸胎瘤占常见睾丸肿瘤前三位,分别为中青年、老年人、青少年最常见肿瘤,>55岁患者还需注意继发性肿瘤的存在;精原细胞瘤与淋巴瘤两者肿物平均最大径相当,约6 cm,前者均发生于单侧睾丸,后者具有累及双侧睾丸的倾向;年龄及部位对精原细胞瘤与淋巴瘤的鉴别诊断具有一定的提示作用,精原细胞瘤总体预后良好,淋巴瘤以原发性弥漫大B细胞性多见且预后不佳。

Objective To investigate the incidence,clinicopathological characteristics of testicular tumors,analyze the prognosis of common malignant tumors,and provide more references for clinical diagnosis and treatment by reviewing the literature.Methods A total of 61 cases of testicular tumors confirmed by pathology from 2008 to 2019 were collected,and their clinical data,including age,location of the tumor,tumor size,treatment course,and prognosis were documented and analyzed.Results The 61 patients aged 5 months to 88 years old,with a median age of 35.5 years.Pathological types included seminama(18 cases,29.5%),non-seminoma(25 cases,41.0%),haematolymphoid tumors(16 cases,26.2%),secondary tumours(2 cases,3.3%),respectively.There were 18 cases of seminoma,with a median age of 37 years,and average tumor size of 6 cm,and all cases were unilateral,among which 6 had a history of cryptorchidism;the pathological subtypes included classic type and anaplastic type;the median follow-up time was 36.5 months,and all the 14 patients with follow-up data were alive,with good prognosis.There were 16 cases of lymphoma,with a median age of 64 years,the average tumor size of 5.7 cm;4 of the 16 cases were bilateral;the median follow-up time was 35.5 months,and 4 of the 11 patients with follow-up data died,with poor prognosis.There were 15 cases of teratoma,with a median age of 15 years.Conclusion Seminoma,lymphoma,and teratoma shared the top three commonly occurring cancers of testis,and had the highest incidence among the middle-aged,the elderly,and the adolescents,respectively.Patients over 55 years old also need to be aware of secondary tumors.The average tumor size of both seminoma and lymphoma is approximately 6 cm.The former were almost unilateral,while the latter has a tendency to be bilateral.Age and location were helpful in establishing an accurate differential diagnosis between seminoma and lymphoma.Seminoma presented favorable outcomes,while lymphoma had relatively poor prognosis and the most commonly type was primary diffuse large B celllymphoma.