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摘要: 目的 总结儿童睾丸良性肿瘤的临床资料，探讨其围手术期评估的特点，提高保留睾丸手术的可及性。方法 回顾性分析2010年1月—2023年6月中山大学肿瘤防治中心收治的睾丸肿瘤患儿的临床资料，其中睾丸良性肿瘤44例。收集睾丸良性肿瘤患儿术前评估资料、术后病理结果及随访资料，统计分析其特点。结果 44例患儿中左侧17例，右侧25例，双侧2例；年龄3个月~12岁，中位年龄8岁，2岁及以下13例。其中畸胎瘤22例，表皮样囊肿18例，腺瘤2例，间皮囊肿2例。所有患儿均常规行睾丸癌肿瘤标志物检测，其中2例血清甲胎蛋白(alpha fetoprotein，AFP)升高，超声检查考虑良性，均行根治性睾丸切除术；术前超声检查提示恶性肿瘤4例，肿瘤标志物均正常范围，其中3例行根治术，1例行保留睾丸手术。共23例患儿行根治性睾丸切除术，21例患儿行保留睾丸手术。术后随访6~87个月，中位随访时间44个月。所有受访患儿均未见肿瘤复发或者残留睾丸萎缩等并发症。结论 儿童睾丸肿瘤中良性肿瘤占有较高比例，应重视儿童睾丸肿瘤围手术期评估，避免过度治疗。Abstract: Objective To summarize the clinical data of benign testicular tumors, and explore the feasibility and effectiveness of testis-sparing surgery for testicular tumors in children.Methods A retrospective analysis of clinical data on pediatric testicular tumors admitted to Cancer Center, Sun Yat-sen University from January 2010 to June 2023 was performed. Among them, there were 44 cases of benign testicular tumors. Preoperative evaluation data, postoperative pathological results, and follow-up data of patients with benign testicular tumors were collected, and analyzed.Results Among 44 pediatric patients, there were 17 on the left side, 25 on the right side, and 2 on both sides. The age range was from 3 months to 12 years old, and the median age was 8 years old. Thirteen cases were younger than 2 years old. Among them, there were 22 cases of teratoma, 18 cases of epidermoid cyst, 2 cases of adenoma, and 2 cases of mesothelial cyst. All children were routinely tested for testicular cancer markers. Among them, 2 cases presented with elevated serum alpha fetoprotein (AFP) level, but ultrasound examination considered benign lesions. Then, both of them underwent radical orchiectomy. Preoperative ultrasound examination revealed malignant tumors in 4 patients, whose tumor markers were all within normal range. Among them, 3 underwent radical surgery and 1 underwent testis-sparing surgery. A total of 23 children underwent radical orchiectomy, while 21 cases underwent testis-sparing surgery. The follow-up period was 6-87 months, with a median time of 44 months. All interviewed patients did not have any complications such as tumor recurrence or residual testicular atrophy.Conclusion Benign tumors account for a high proportion of testicular tumors in children, so perioperative evaluation of testicular tumors in children should be emphasized to avoid overtreatment.
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Key words:
- children /
- testicular tumor /
- benign tumors /
- testis-sparing surgery /
- perioperative evaluation
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表 1 2组患儿临床资料比较
例，M(P25，P75)，X±S 项目 根治组(23例) 保留组(21例) P值 年龄/岁 7(0.2，12.0) 8(0.4，12.0) 0.432 年龄 < 2岁 8 5 0.426 最大径/cm 2.2(0.9，5.4) 1.5(0.4，2.8) 0.038 最大径 < 2.0 cm 8 18 0.001 2020年前手术 19 9 0.006 AFP值升高 2 0 0.489 超声边界不清 3 4 0.587 超声见低回声 0 2 0.222 超声诊断恶性 3 1 0.609 术中冷冻病理 1 12 < 0.001 手术时间/min 78.3±47.3 93.3±44.5 0.375 术后住院时间/d 4.3±2.1 3.8±1.5 0.417 
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| 引用本文: |
殷坤党, 刘振华, 李志勇, 等. 儿童睾丸良性肿瘤44例报告[J]. 临床泌尿外科杂志, 2024, 39(8): 689-691. doi: 10.13201/j.issn.1001-1420.2024.08.007
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| Citation: |
YIN Kundang, LIU Zhenhua, LI Zhiyong, et al. Report on 44 cases of testicular benign tumors in children[J]. J Clin Urol, 2024, 39(8): 689-691. doi: 10.13201/j.issn.1001-1420.2024.08.007
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