精巣腫瘍患者の対側精巣組織の検討

Abstract

20例の成人精巣腫瘍症例の対側精巣生検組織について, Johnsen's mean score countおよび精細管壁の肥厚の有無と各腫瘍パラメータにつき検討した.対側精細管壁の肥厚は原発腫瘍重量150 g以上の症例で明らかに高率であり, 精上皮脱落も多くの精細管で認められた.したがって, 対側精巣の造精機能障害は腫瘍発生そのものが主因であると考えられたが, 精細管壁の変化なく高度な造精機能障害を認めた例もあり, 対側精巣機能障害の原因は多様であることが示唆された

Biopsy of contralateral testis of 20 patients with an unilateral testicular tumor was carried out to evaluate the morphological changes of the contralateral testis caused by the tumor. Serum beta-chorionic gonadotropin (beta-hCG), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and alpha-fetoprotein (AFP) levels before orchiectomy were examined as a function influencing morphological changes of the contralateral testis. Typical carcinoma in situ was found in a case of ipsilateral testis. The presence of a few atypical germ cells, however, was the only finding of the contralateral testis of three patients. Five of 20 patients revealed hypospermatogenesis in the contralateral intact testis. Most of the other patients also showed sloughing of germinal epithelium suggesting disorder of spermatogenesis. Johnsen's mean score count and tubular wall thickening were related to neither clinical stages, ESR, serum beta-hCG, AFP, LH nor FSH levels. Tubular wall thickening was observed in 8 of 10 patients with a tumor weighting over 150 g, but was found in only 1 of 10 patients with a lighter tumor (p less than 0.01).