Cast J E, Nelson W M, Early A S, Biyani S, Cooksey G, Warnock N G, Breen D J
Department of Radiology, Hull and East Yorkshire NHS Trust, Hull Royal Infirmary, Anlaby Rd., Hull HU3 2JZ, United Kingdom.
AJR Am J Roentgenol. 2000 Dec;175(6):1703-6. doi: 10.2214/ajr.175.6.1751703.
Considerable accrued evidence points to an association between testicular microlithiasis, intratubular germ cell neoplasia, and testicular tumor. This study assesses both the prevalence of testicular microlithiasis revealed on sonography in a referred population and the concurrent tumor risk.
Over a 32-month period (April 1996 through November 1998), 4892 scrotal sonographic examinations were performed in 4819 patients at four referral centers. All patients underwent high-resolution (7- to 10-MHz) imaging. Using a computerized word search (n = 4102; testicular microlithiasis, calcification, microliths, calcific foci, tumor, neoplasm, cancer, hyperecho, hypoecho, heterogen, and carcinoma) and manual retrieval (n = 790), cases of tumor, testicular microlithiasis (>5 microliths per sonogram), and testicular microlithiasis plus tumor were pulled and retrospectively reviewed. The presence and type of tumor were confirmed at histology after orchidectomy.
Fifty-four tumors were found among 4892 scrotal sonograms (28 seminomas, 14 teratomas, 8 mixed germ cell tumors, 2 Leydig cell tumors, and 2 non-Hodgkin's lymphomas). Testicular microlithiasis was present in 33 patients, giving a prevalence of 0.68%. Concurrent tumor and testicular microlithiasis were detected in seven patients, a relative risk of tumor in testicular microlithiasis was 21.6-fold (95% confidence limits: 10. 6-fold, 44.2-fold). In one patient with testicular microlithiasis, a previous orchidectomy for mixed germ cell tumor had been performed (not included in the relative risk calculation).
In a referred population of 4819 patients the prevalence of testicular microlithiasis was 0.68% and the relative risk of concurrent tumor was 21.6-fold. Sonographic surveillance of testicular microlithiasis cases for tumor is mandatory.
大量累积证据表明睾丸微结石症、管内生殖细胞瘤变与睾丸肿瘤之间存在关联。本研究评估了在转诊人群中超声检查发现的睾丸微结石症的患病率以及同时存在的肿瘤风险。
在32个月期间（1996年4月至1998年11月），四个转诊中心对4819例患者进行了4892次阴囊超声检查。所有患者均接受高分辨率（7至10兆赫兹）成像。通过计算机化文字搜索（n = 4102；搜索词为睾丸微结石症、钙化、微结石、钙化灶、肿瘤、瘤、癌症、高回声、低回声、不均匀及癌）和人工检索（n = 790），提取出肿瘤、睾丸微结石症（每个超声图像上>5个微结石）以及睾丸微结石症合并肿瘤的病例，并进行回顾性分析。睾丸切除术后通过组织学检查确认肿瘤的存在及类型。
在4892次阴囊超声检查中发现54例肿瘤（28例精原细胞瘤、14例畸胎瘤、8例混合性生殖细胞瘤、2例Leydig细胞瘤和2例非霍奇金淋巴瘤）。33例患者存在睾丸微结石症，患病率为0.68%。7例患者同时检出肿瘤和睾丸微结石症，睾丸微结石症患者发生肿瘤的相对风险为21.6倍（95%置信区间：10.6倍，44.2倍）。1例患有睾丸微结石症的患者此前因混合性生殖细胞瘤接受过睾丸切除术（未纳入相对风险计算）。
在4819例转诊患者中，睾丸微结石症的患病率为0.68%，同时发生肿瘤的相对风险为21.6倍。对睾丸微结石症病例进行超声监测以排查肿瘤是必要的。
