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首页> 外文期刊>Urology >Significance of primary tumor size and preorchiectomy serum tumor marker level in predicting pathologic stage at retroperitoneal lymph node dissection in clinical Stage A nonseminomatous germ cell tumors.
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Significance of primary tumor size and preorchiectomy serum tumor marker level in predicting pathologic stage at retroperitoneal lymph node dissection in clinical Stage A nonseminomatous germ cell tumors.

机译：原发性肿瘤大小和睾丸切除术前血清肿瘤标志物水平在预测临床A期非精原细胞生殖细胞肿瘤腹膜后淋巴结清扫术的病理分期中的意义。

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OBJECTIVES: To determine whether the size of the primary tumor and degree of preorchiectomy serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-hCG) elevation predict for retroperitoneal pathologic findings in patients with clinical Stage A nonseminomatous germ cell tumor undergoing primary retroperitoneal lymph node dissection. METHODS: The testicular cancer database was queried to identify patients with clinical Stage A nonseminomatous germ cell tumor with normalization of serum tumor markers after orchiectomy who had undergone retroperitoneal lymph node dissection. A total of 779 patients were identified. The preorchiectomy serum tumor marker level was recorded and categorized into the following subsets: AFP: less than 20 (normal), 20 to 100, 100 to 1000, and more than 1000 ng/dL; and beta-hCG: less than 5.0 (normal), 5 to 100, 100 to 1000, and more than 1000. The association between AFP, beta-hCG, and primary tumor size and retroperitoneal pathologic findings was determined. RESULTS: The retroperitoneal pathologic examination revealed metastatic disease in 207 patients (26.6%). The preorchiectomy serum beta-hCG level, as a categorical variable, was not predictive of positive retroperitoneal pathologic findings (P = 0.187). The preorchiectomy serum AFP did predict for positive retroperitoneal pathologic findings, with lower serum AFP levels associated with a greater incidence of retroperitoneal metastasis (P <0.001). The primary tumor size was not predictive of positive retroperitoneal pathologic findings (P = 0.113). CONCLUSIONS: Neither the primary tumor size nor the preorchiectomy beta-hCG level was predictive of retroperitoneal metastases. However, a normal preorchiectomy AFP level was associated with a greater incidence of retroperitoneal metastases.
机译：目的：为了确定原发性肿瘤的大小和睾丸切除术前血清甲胎蛋白（AFP）和β-人绒毛膜促性腺激素（β-hCG）升高的程度是否可预测正在接受临床A期非精原细胞生殖细胞肿瘤的患者的腹膜后病理发现原发性腹膜后淋巴结清扫术。方法：查询睾丸癌数据库，以鉴定经过睾丸切除后腹膜后淋巴结清扫的临床A期非精原性生殖细胞肿瘤患者，其血清肿瘤标志物正常化。总共确定了779名患者。记录睾丸切除术前血清肿瘤标志物的水平并将其分类为以下亚组：AFP：小于20（正常），20至100、100至1000和大于1000 ng / dL;和β-hCG：小于5.0（正常），5-100、100-1000和大于1000。确定了AFP，β-hCG与原发肿瘤大小和腹膜后病理发现之间的关联。结果：腹膜后病理检查发现207例患者有转移性疾病（26.6％）。睾丸切除术前血清β-hCG水平作为分类变量不能预测腹膜后病理阳性（P = 0.187）。睾丸切除术前血清AFP确实预示着腹膜后病理学阳性，而血清AFP水平降低与腹膜后转移的发生率较高相关（P <0.001）。原发肿瘤大小不能预示腹膜后病理学阳性（P = 0.113）。结论：原发肿瘤大小或睾丸切除术前β-hCG水平均不能预测腹膜后转移。但是，正常的睾丸切除术前AFP水平与腹膜后转移的发生率较高相关。

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