Horan G, Rafique A, Robson J, Dixon A K, Williams M V
Oncology Department, Box 193, Addenbrooke's Hospital, Hill's Road, Cambridge, CB2 2QQ, UK.
Br J Cancer. 2007 Mar 26;96(6):882-5. doi: 10.1038/sj.bjc.6603657.
To evaluate the role of chest CT in the initial staging of testicular seminomatous germ cell tumours. All patients referred to Addenbrooke's Hospital with testicular seminoma from 1 January 2000 to 31 December 2005 were included and case notes retrospectively reviewed. One hundred and eighty-two patients with testicular seminoma were identified, with a median age of 37 years (range 19-74). Most patients had stage I disease (86%). Twenty-four patients had abnormal abdominal CT findings. One hundred and fifty-eight had normal abdominal CT findings but, on initial staging, chest CT reported abnormalities in 13 patients, which, on further follow-up CT were deemed to be irrelevant to the diagnosis of seminoma. There was a further patient with a normal CT abdomen in whom chest CT detected obvious metastatic disease, which was seen on chest x-ray. Overall 18 cases required additional investigations and follow-up for abnormalities subsequently found to be benign. There was a false-positive rate of 10% for initial staging with chest CT. This is the largest reported series of staging CT chest in testicular seminoma. In all patients with normal abdominal CT, normal chest x-ray and abnormal chest CT, subsequent follow-up investigations demonstrated that the lung lesions were incidental findings.
评估胸部CT在睾丸精原细胞瘤初始分期中的作用。纳入2000年1月1日至2005年12月31日转诊至阿登布鲁克医院的所有睾丸精原细胞瘤患者，并对病历进行回顾性分析。共确定182例睾丸精原细胞瘤患者，中位年龄37岁（范围19 - 74岁）。大多数患者为I期疾病（86%）。24例患者腹部CT检查结果异常。158例患者腹部CT检查结果正常，但在初始分期时，胸部CT报告13例患者有异常，进一步随访CT检查发现这些异常与精原细胞瘤诊断无关。另有1例患者腹部CT正常，胸部CT检测到明显的转移性疾病，胸部X线检查也可见。总体而言，18例患者因后续发现为良性的异常情况需要进一步检查和随访。胸部CT初始分期的假阳性率为10%。这是已报道的最大系列睾丸精原细胞瘤分期胸部CT研究。在所有腹部CT正常、胸部X线正常但胸部CT异常的患者中，后续随访检查表明肺部病变为偶然发现。
