睾丸生殖细胞肿瘤42例的临床特征分析

The Clinical Features of Testicular Germ Cell Tumor

目的 探讨睾丸生殖细胞肿瘤的临床特征。方法 回顾性分析收治的 42例睾丸生殖细胞肿瘤患者的临床资料。患者均行根治性睾丸切除术。转移可疑及非精原细胞瘤病人加行腹膜后淋巴结清除术。术后辅以化疗或放疗。结果 3 9例获随访的患者中位随访时间为 9.4年。I期和II～III期患者无瘤生存率分别为 91.7%( 2 2 / 2 4)和 60 .0 %( 9/ 15 ) ;总生存率为 79.5 %( 3 1/ 3 9)。结论 早期睾丸生殖细胞肿瘤行根治性切除术后辅以适当化疗或放疗 ,预后良好 ;隐睾是睾丸肿瘤的高危因子 ,且成年后行睾丸固定术 ,对日后癌变保护作用有限 ;患侧睾丸肿瘤切除后 。

Objective To investigate the clinical features of testicular germ cell tumors. Methods The clinical data of 42 patients with testicular germ cell tumors admitted were analysed retrospectively.The cardinal symptoms were painless testicular mass,diffuse testicular pain,swelling and hardness.All patients underwent testicular tumor orchiectomy and supplement with radiation or chemotherapy.Metastasis suspect and non seminoma patients underwent retroperitoneal lymph node dissection. Results The diseased free survical rate were 91.7%(22/24),60.0%(9/15) for patients in stage I and for those in stage II～III.The total survical rate was 79.5%(31/39). Conclusion Patients with early testicular tumor orchiectomy is needed and should supplement with radiation or chemotherapy.Prognosis is good.Retained testis is high risk factor and orchidopexy can only offer a limited protection against future malignancy if preformed on patients over 10 years old.Active surveillance and intensive follow up is needed for patients who have undergone orchiectomy,including the other testis.