Seminoma 27例の検討 : 特にstage1seminomaにおけるHCG-β測定の意義とstage1seminomaに対する後腹膜リンパ節郭清術の検討

Abstract

Between August, 1968 and March, 1985, we treated 27 patients with testicular seminoma. The histopathological type was typical seminoma in 23 (85%) and anaplastic seminoma in 4 (15%). Their clinical stages were classified into stage I for 17 patients (63%), 7 patients (25%) in II and 3 (12%) in III. Tumor markers, alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG-beta), were determined in 16 patients. None of them showed an elevated level of AFP, but 7 (43.8%) had elevated hCG-beta in the peripheral vein. The hCG-beta in the spermatic vein on the tumor side was elevated in 12 out of 14 patients (88.9%). The hCG-beta level in the spermatic vein on the tumor side was significantly higher than that in the peripheral vein in 10 patients with stage I seminoma. This finding suggests that the determination of hCG-beta in the spermatic vein would give us more accurate information on the production of hCG-beta in seminoma. Although the elevation of the hCG-beta level in pure seminoma has been supposed to be a poor prognostic factor, our results indicated that a mild to moderate elevation of hCG-beta in stage I seminoma did not always imply a poor clinical course, first, because none of these 10 patients, even with an elevated hCG-beta, who underwent retroperitoneal lymph node dissection (RPLND), had microscopic metastasis, and second, because none of these have had a recurrence of the disease up to now.(ABSTRACT TRUNCATED AT 250 WORDS)