论文部分内容阅读
背景与目的:目前婴幼儿Ⅰ期睾丸卵黄囊瘤早期诊断困难,且行睾丸癌根治术后的治疗方案不确定。本文旨在对此进行深一步的探讨。方法:回顾性分析中山大学肿瘤防治中心2001年7月至2007年6月收治的10例婴幼儿临床Ⅰ期睾丸卵黄囊瘤的临床资料。结果:10例患者11侧睾丸术前行阴囊B超检查提示睾丸实性肿物,呈低回声或不均匀回声;9例患者血清甲胎蛋白(alpha fetoprotein,AFP)水平升高。10例均行睾丸癌根治术,术前均未行化疗,术后病理检查确诊卵黄囊瘤。其中1例双侧睾丸卵黄囊瘤和1例病理报告见卵黄囊瘤脉管浸润者予以辅助化疗。本组10例均未行腹膜后淋巴结清扫术。9例患者平均随访3年多未见复发和进展,1例双侧睾丸卵黄囊瘤患者辅助化疗结束后随访23个月时发现腹膜后及肺部转移,再次化疗后完全缓解。结论:婴幼儿临床Ⅰ期睾丸卵黄囊瘤可根据B超和血清AFP检查结果初步诊断。行单纯睾丸癌根治术即可达到良好效果,不必行腹膜后淋巴结清扫术。对于高危的患儿可予以辅助化疗。
BACKGROUND & OBJECTIVE: At present, stage Ⅰ testicular yolk sac tumor is difficult to diagnose in infants and young children and the treatment plan after radical operation of testicular cancer is uncertain. This article aims to further explore this. Methods: The clinical data of 10 cases of clinical stage Ⅰ testicular yolk sac tumor from July 2001 to June 2007 in Cancer Center of Sun Yat-sen University were retrospectively analyzed. Results: Ultrasound examination of the scrotal of 11 testicular testes in 10 patients showed hypoechoic or hypoechoic edema; 9 patients had elevated serum alpha-fetoprotein (AFP) levels. Ten patients underwent radical testicular cancer, and no chemotherapy was performed before surgery. Yolk sac tumor was confirmed by postoperative pathological examination. One case of bilateral testicular yolk sac tumor and one case of pathological report see yolk sac tumor infiltration were adjuvant chemotherapy. None of the 10 patients underwent retroperitoneal lymph node dissection. Nine patients were followed up for an average of 3 years without recurrence and progression. One patient with bilateral testicle yolk sac tumor found retroperitoneal and pulmonary metastases after 23 months of follow-up, and was completely relieved after chemotherapy. Conclusion: The clinical stage Ⅰ testicular yolk sac tumor in infants and young children can be diagnosed preliminarily according to the results of B-mode ultrasonography and serum AFP examination. Line simple testicular cancer radical surgery can achieve good results, without retroperitoneal lymph node dissection. For high-risk children may be adjuvant chemotherapy.