49例睾丸癌患者的临床特点及诊疗

Clinical characteristics and treatment of 49 cases of testicular cancer

目的探讨睾丸癌患者的临床特点及诊疗。方法回顾性分析北京大学肿瘤医院泌尿外科行手术治疗的49例睾丸癌患者的临床资料。结果49例患者中,术前甲胎蛋白(AFP)升高11例,均≤44岁;人体绒毛膜促性腺激素(β-hCG)升高21例,其中19例≤44岁;乳酸脱氢酶(LDH)升高20例,其中18例≤44岁。术后2周AFP异常2例,均≤44岁;β-hCG异常6例,其中5例≤44岁;LDH均正常。49例患者均行睾丸癌根治术,其中6例行腹膜后淋巴结清扫术,23例患者术后行放射治疗/化学治疗。结论AFP、β-hCG和LDH对<45岁睾丸癌患者诊断和评估意义更大。需要开发具有更高灵敏度和特异性的标志物。腹膜后淋巴结清扫可以作为临床初始治疗。

Objective To explore the clinical characteristics and treatment outcome of testicular cancer.Methods To review retrospectly the clinical data of 49 patients who were diagnosed with testicular cancer and treated with operation in the Urology Department of Peking University Cancer Hospital.Results Among the 49 patients,11 had elevated preoperative alpha fetal protein(AFP)levels,all have the age as≤44 years;21 had elevatedβ-human chorionic gonadotropin(β-hCG)level,including 19 cases with age as≤44 years;20 had elevated lactate dehydrogenase(LDH),including 18 cases with the age as≤44 years.Two weeks after operation,there were 2 cases of abnormal AFP,both≤44 years old;6 cases of abnormalβ-hCG,including 5 cases≤44 years old;LDH were all normal.All patients underwent radical resection of testicular cancer,including 6 patients with retroperitoneal lymph node dissection(RLND),and 23 patients with postoperative radiotherapy/chemotherapy followed.Conclusions The significance of AFP,β-hCG and LDH is greater for the diagnosis and evaluation of patients<45 years old.Markers with higher sensitivity and specificity are needed for evaluation.RLND can be an option for initial treatment.