通过检查阴囊多普勒超声和血清肿瘤标志物确定睾丸小肿块的方法

IF 0.1 Q4 UROLOGY & NEPHROLOGY
I. Erol
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引用次数: 0

摘要

目的:在我们的研究中,我们回顾性分析了我们临床上进行的睾丸根治术的病理结果,并将术前彩色多普勒超声(CDUSG)检查结果与血清肿瘤标记物(STM)阴性的睾丸小肿块(SmTM)相关联。材料和方法:对2010年1月至2021年1月期间接受睾丸根治性切除术治疗经CDUSG检测到的睾丸内实体性病变的男性患者(n=98)进行回顾性评估。所有患者均根据年龄、睾丸萎缩、回声、肿瘤病变大小、睾丸触诊能力、术前STM和术后病理结果进行评估。结果:58例(59.2%)患者术前至少有一种STM表达升高。术后仍有25例(25.5%)患者出现STM升高;81例(82.7%)患者有恶性病理表现。患者平均年龄为39.47±15.20岁,而良性病变患者的平均年龄高于恶性病变患者(p=0.008)。恶性病变的平均大小显著大于良性病变(5.4vs 3.5cm;p=0.033)。统计上,STM升高,年龄降低,CDUSG异质性,发现大的病变大小是预测恶性肿瘤的参数。虽然20例STM阴性患者中有9例(45%)病变小于3cm为良性,但8例STM阳性患者中有6例(75%)病变小于1.5cm为良性。特别是在患有SmTM的STM阴性患者中,CDUSG可以合理地指导决策阶段,尽管它不能提供明确的诊断。根治性睾丸切除术是治疗所有睾丸实体病变的传统方法,会导致良性病变患者进行不必要的治疗,因此STM-阴性、无法触及的SmTM应首选睾丸切除术,因为癌症的风险较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Determining an Approach to Small Testicular Masses by Examining Scrotal Doppler Ultrasonography and Serum Tumor Markers
Objective: In our study, we retrospectively analyzed the pathology results of radical orchiectomy operations performed in our clinic and to correlate preoperative color Doppler ultrasonography (CDUSG) findings with small-testicular masses (SmTM) with negative serum tumor markers (STM). Materials and Methods: Male patients (n=98) who underwent radical orchiectomy between January 2010 and January 2021 to treat intratesticular solid lesions that were detected via CDUSG were evaluated retrospectively. All patients were evaluated in terms of age, atrophic testis, echogenicity, size of tumoral lesions, testicular palpability, preoperative STM and postoperative pathology results. Results: Expression of at least one STM was elevated in 58 (59.2%) patients preoperatively. STM elevation continued to occur in 25 (25.5%) patients postoperatively; furthermore, 81 (82.7%) patients presented with malignant pathology. The mean age of patients was 39.47±15.20 years, whereas the mean age of patients with benign pathology was higher than patients with malignant pathology (p=0.008). The mean size of malignant lesions was significantly greater than that of benign lesions (5.4 vs 3.5 cm; p=0.033). Statistically elevated STM, lower age, heterogeneity in CDUSG, and large lesion size were found as parameters predicting malignancy. Although lesions in 9 (45%) of 20 STM-negative patients with a lesion smaller than 3 cm were benign, benign pathology was detected in 6 (75%) of 8 STM-negative patients with a lesion smaller than 1.5 cm. Conclusion: CDUSG plays an important role in detecting small non-palpable masses. Especially in STM-negative patients with a SmTM, CDUSG can reasonably guide the decision-making phase although it cannot provide definitive diagnosis. Radical orchiectomy, which is the traditional approach for all solid testicular lesions, leads to unnecessary treatment in patients with benign lesions, so testicular-sparing surgery should be preferred in STM-negative non-palpable SmTMs because the risk of cancer is low.
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来源期刊
Journal of Urological Surgery
Journal of Urological Surgery UROLOGY & NEPHROLOGY-
自引率
33.30%
发文量
42
审稿时长
16 weeks
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