本文選題：睪丸腫瘤 + 病理診斷�。� 參考：《北京大學學報(醫(yī)學版)》2017年04期

【摘要】：目的:睪丸混合性生殖細胞瘤是混有胚胎性癌、絨毛膜癌、卵黃囊瘤、畸胎瘤、精原細胞瘤等兩種或以上成分的睪丸腫瘤,臨床較為少見且惡性度較高,本文將總結其臨床特征并優(yōu)化其治療方式。方法:回顧性分析北京大學第三醫(yī)院自1994年5月至2016年11月收治22例睪丸混合性生殖細胞瘤患者的臨床資料,使用統(tǒng)計分析并結合相關文獻進行討論。結果:22例患者平均年齡為(30.8±10.4)歲,隱睪率為13.6%。腫瘤最大徑平均為(5.1±2.7)cm。病理結果提示12例(54.5%)包含2種不同生殖細胞腫瘤成分,7例(31.8%)包含3種不同腫瘤成分,2例(9.2%)包含4種不同腫瘤成分,1例(4.5%)包含5種不同腫瘤成分。腫瘤成分分析包括卵黃囊瘤(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%)、絨毛膜癌(4例,18.1%)、精原細胞瘤(6例,27.3%)。根據(jù)美國癌癥學會腫瘤分期,19例為Ⅰa期腫瘤,2例為Ⅱa期腫瘤,1例為Ⅲa期腫瘤。術前與術后1年內血清腫瘤標志物人絨毛膜促性腺激素、甲胎蛋白和乳酸脫氫酶的平均值分別為414.50 MIU/m L、242.95μg/L、196.95 U/L(術前)和17.20 MIU/m L、90.20μg/L、183.70 U/L(術后),術前與術后1年內組間比較所得P值分別為0.079、0.043和0.624。14例患者術后行腹膜后淋巴結清掃術。術后大部分患者長期生存(94.4%)。結論:睪丸根治性切除術后聯(lián)合腹膜后淋巴結清掃以及必要的放化療等綜合治療可能有助于控制腫瘤,并使大部分患者獲得長期生存。
[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 鹵10.4 years old, and the cryptorchidism rate was 13.6%. The mean maximum diameter of tumor was 5.1 鹵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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