| Objective To improve the understanding of the pathological features and prognosis of testicular tumor in clinical work.Methods The clinical data of 86 patients with testicular tumor from June 2010 to June 2018 were collected,and the pathological types,treatment methods,tumor biomarkers,fertility and sexual function of testicular tumor were counted.The correlation between various indicators and the influencing factors of prognosis were analyzed retrospectively.Results The patients were aged from 3 months to 61 years,with an average age of 29.37 years,including 40 cases of seminoma,36 cases of non-seminoma germ cell tumors(NSGCTs),5 cases of lymphoma,4 cases of stromal tumor,and 1 case of adenosarcoma.Tumor complicated with cryptorchidism in 14 cases.Teratoma and yolk sac tumor are basically seen in pediatric patients;seminoma,embryonal carcinoma and other GCTs are high in young adults,especially in 20-40 years old;stromal tumor,lymphoma and other non-germ cell tumors are common in patients over 45 years old.?-HCG and AFP are normal in non-germ cell tumors,and are expressed differently in different types of GCTs.PLAP,CK and CD 117,as immunohistochemical indicators,are helpful for the identification of tumor types.Follow-up ranged from 4 to 102 months,with a median time of 43 months.3 patients were lost to follow-up,and 10 died(including 4 cases of seminoma,3 cases of embryonal carcinoma,2 cases of mixed germinoma,and 1 case of choriocarcinoma).Pathology type and clinical stage is to determine the main factors of the prognosis,the germ cell tumors and benign NSGCTs are in good prognosis,which can survive for a long time;seminoma which 1 year survival rate was 94.3%,3 years and 5 years survival rate reached 87.0%is better compared with malignant NSGCTs which 1 year survival rate was 81.3%,3 year survival rate was 61.9%,the 5-year survival rate was 54.1%(P<0.05);Mortality rates are different by stages(stage ? 5.17%,? 40%,?66.67%);Mortality was associated with tumor size(<4cm 3.33%,4-7cm 9.52%,7cm 35.71%,2=12.42,P=0.002),and with cryptorchidism(x2=6.42,P=0.003).Staging and size were independent prognostic factors(P=0.039,HR=3.06;P=0.014,HR=2.626);The risk of death associated with cryptorchidism was increased(P=0.006,HR=5.785),but it was a non-independent factor(P=0.181).After treatment,the quality of life of 16.44%patients was affected,61.11%patients had fertility disorder,and 38.59%had sexual dysfunction..Conclusion1.Testicular tumor are of multiple histopathological origins and have obvious age distribution characteristics.seminoma are the most common type and non-GCTs are rare.Pediatric patients should first consider benign NSGCTs such as teratoma,while young and middle-aged patients have a high incidence of seminoma and malignant NSGCTs,while elderly patients should be aware of the occurrence of testicular non-GCTs.2.Tumor biomarkers have good value in differential diagnosis.AFP is negative in seminoma.?-HCG and LDH can be increased to different degrees in seminoma.The expression of various biomarkers in NSGCTs was significantly different due to the different tissue components.Tumor biomarkers are usually negative in non-GCTs.3.Prognostic factors of testicular tumor included tumor pathological type,stage,size and concomitant cryptorchidism.The prognosis of non-GCTs and benign NSGCTs are quiet good,while that of malignant NSGCTs are poor.The prognosis of seminoma is between the former two.Large tumors,high stage and concomitant cryptorchidism increase the risk of death.4.The fertility and sexual function in testicular tumor patients decreased,which is still an urgent problem to be solved. |
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