Clinical study of testicular germ cell tumors

Abstract

精巣胚細胞腫瘍65例68精巣を臨床的に検討した.36精巣(53.7%)はセミノーマで, 残りはnon-seminomatous germ cell testicular tumor(NSGCTT)であった.セミノーマ症例のうち31例(88.6%)はI期でそれ以外は受診時に転移巣を有していた.NSGCTTのうち22例(68.8%)はI期であった.セミノーマ及びNSGCTT症例の平均年齢は各々40.4, 29.2歳であった.39例(60.0%)は右側, 23例(35.4%)は左側, 3例(4.6%)は両側性であった.5例は停留精巣の既往を有していた.49例(73.1%)において主訴は無痛性精巣腫大であった.症状発現から受診迄の期間はNSGCTT症例よりセミノーマの方が長かった(平均10.9ヵ月と3.4ヵ月).Immunosuppressive acidic protein(IAP)はalpha-feto protein(AFP), beta-human chorionic gonadotropin(betahCG), lactic dehydrogenase(LDH)と共に腫瘍マーカーとして有用であった

A clinical statistical analysis on 65 patients with 68 testicular germ cell tumors was performed. Thirty-six testes (53.7%) had seminomas and the remainder non-seminomatous germ cell testicular tumors (NSGCTTs). Of the seminomas, 31 (88.6%) were in stage I and the others showed distant metastases at presentation. Of the 32 NSGCTTs, 22 (68.8%) were in stage I. The average ages of the patients with seminomas and NSGCTTs were 40.4 and 29.9 years, respectively. Thirty-nine patients (60.0%) had tumors on the right side, 23 (35.4%) on the left and 3 (4.6%) in both testes. Five patients had a past history of cryptorchidism. Chief complaints in 49 patients (73.1%) were a painless scrotal mass. The interval from clinical onset to presentation was longer in seminoma patients than in NSGCTT patients (10.9 months on average versus 3.4 months). Immunosuppressive acidic protein (IAP) was a useful diagnostic tumor marker as well as alpha-feto protein (AFP), beta-human chorionic gonadotropin (beta-hCG) and lactic dehydrogenase (LDH). We adopted a surveillance policy in more than half of the stage I patients and obtained acceptable results. In the remaining cases, therapies including combination chemotherapy, radiation and salvage operation were performed after orchiectomy. The three-year survival rate was 98.0, 100.0 and 26.7%, for stage I, II and III patients respectively.