睾丸混合性生殖细胞瘤综合治疗的长期随访经验

发布时间：2018-05-11 10:50

  本文选题：睾丸肿瘤 + 病理诊断　； 参考：《北京大学学报(医学版)》2017年04期

【摘要】：目的:睾丸混合性生殖细胞瘤是混有胚胎性癌、绒毛膜癌、卵黄囊瘤、畸胎瘤、精原细胞瘤等两种或以上成分的睾丸肿瘤,临床较为少见且恶性度较高,本文将总结其临床特征并优化其治疗方式。方法:回顾性分析北京大学第三医院自1994年5月至2016年11月收治22例睾丸混合性生殖细胞瘤患者的临床资料,使用统计分析并结合相关文献进行讨论。结果:22例患者平均年龄为(30.8±10.4)岁,隐睾率为13.6%。肿瘤最大径平均为(5.1±2.7)cm。病理结果提示12例(54.5%)包含2种不同生殖细胞肿瘤成分,7例(31.8%)包含3种不同肿瘤成分,2例(9.2%)包含4种不同肿瘤成分,1例(4.5%)包含5种不同肿瘤成分。肿瘤成分分析包括卵黄囊瘤(16例,72.7%)、成熟畸胎瘤(7例,31.8%)、未成熟畸胎瘤(5例,22.7%)、胚胎性癌(17例,77.3%)、绒毛膜癌(4例,18.1%)、精原细胞瘤(6例,27.3%)。根据美国癌症学会肿瘤分期,19例为Ⅰa期肿瘤,2例为Ⅱa期肿瘤,1例为Ⅲa期肿瘤。术前与术后1年内血清肿瘤标志物人绒毛膜促性腺激素、甲胎蛋白和乳酸脱氢酶的平均值分别为414.50 MIU/m L、242.95μg/L、196.95 U/L(术前)和17.20 MIU/m L、90.20μg/L、183.70 U/L(术后),术前与术后1年内组间比较所得P值分别为0.079、0.043和0.624。14例患者术后行腹膜后淋巴结清扫术。术后大部分患者长期生存(94.4%)。结论:睾丸根治性切除术后联合腹膜后淋巴结清扫以及必要的放化疗等综合治疗可能有助于控制肿瘤,并使大部分患者获得长期生存。
[Abstract]:Objective: testicular mixed germ cell tumor is a testicular tumor with two or more components: embryonic carcinoma, choriocarcinoma, yolk sac tumor, teratoma, spermatocytoma, etc. This article will summarize its clinical features and optimize its treatment. Methods: the clinical data of 22 cases of mixed germ cell tumor of testis treated in the third Hospital of Peking University from May 1994 to November 2016 were analyzed retrospectively. Results the mean age of 22 patients was 30.8 卤10.4 years old, and the cryptorchidism rate was 13.6%. The mean maximum diameter of tumor was 5.1 卤2.7 cm. The pathological results showed that 12 cases (54.5%) contained 2 different germ cell tumor components (7 cases (31.8%) including 3 different tumor components (2 cases 9. 2) including 4 different tumor components (1 case 4. 5) including 5 different tumor components. The analysis of tumor components included yolk sac tumor in 16 cases, mature teratoma in 7 cases, immature teratoma in 5 cases, embryonic carcinoma in 17 cases, choriocarcinoma in 4 cases and seminoma in 6 cases. According to the American Cancer Society tumor staging, 19 cases were stage 鈪，

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