Shah Jay P, Kumar Sanjeev, Bryant Christopher S, Ali-Fehmi Rouba, Malone John M, Deppe Gunter, Morris Robert T
Division of Gynecology Oncology, Wayne State University and Karmanos Cancer Center, Detroit, MI, USA.
Int J Cancer. 2008 Dec 1;123(11):2671-5. doi: 10.1002/ijc.23792.
Yolk sac tumors (YST) are a rare and aggressive germ cell tumor. The objective of this study is to compare the patient characteristics and survival of YST in males and females. Demographic and clinicopathologic information were obtained from the Surveillance, Epidemiology, and End Results Program from 1973 to 2003. Statistical analysis was performed using Independent-sample t-test, chi(2) test, Kaplan-Meier methods and Cox proportional hazards regression. Seven hundred eighty-eight patients were identified, 451 (57%) were males and 337 (43%) were females. The mean age at diagnosis was similar in males and females. The age at diagnosis showed a bimodal distribution with an increased incidence in the first 4 years of life and during the 2nd to 4th decade of life. The most common site of the primary tumor was gonadal, namely testis 336 (42.6%) and ovary 257 (32.6%). Among the extragonadal sites, tumor site of origin differed in males and females. The 5-year survival of extragonadal YST (66%) was worse than gonadal YST (86%) (p < 0.05). The overall median survival for the cohort was 87 months. This was similar in males (81 months) and females (91 months) (p > 0.05). As the year of diagnosis progressed from 1973 to 2003, survival of both males and females with YST consistently improved. The bimodal age distribution of YST generates the hypothesis that sex steroids may play a role in selected YST. Although the overall survival in all YST patients has improved over the past few decades, the primary sites of origin differ in males and females and impact prognosis.
卵黄囊瘤（YST）是一种罕见的侵袭性生殖细胞肿瘤。本研究的目的是比较男性和女性卵黄囊瘤患者的特征及生存率。人口统计学和临床病理信息取自1973年至2003年的监测、流行病学和最终结果计划。采用独立样本t检验、卡方检验、Kaplan-Meier方法和Cox比例风险回归进行统计分析。共识别出788例患者，其中451例（57%）为男性，337例（43%）为女性。男性和女性的诊断时平均年龄相似。诊断年龄呈双峰分布，在生命的前4年以及第二至第四个十年发病率增加。原发肿瘤最常见的部位是性腺，即睾丸336例（42.6%）和卵巢257例（32.6%）。在性腺外部位中，男性和女性的肿瘤起源部位不同。性腺外卵黄囊瘤的5年生存率（66%）低于性腺卵黄囊瘤（86%）（p<0.05）。该队列的总体中位生存期为87个月。男性（81个月）和女性（91个月）相似（p>0.05）。随着诊断年份从1973年进展到2003年，男性和女性卵黄囊瘤患者的生存率持续提高。卵黄囊瘤的双峰年龄分布提出了性类固醇可能在某些卵黄囊瘤中起作用的假设。尽管在过去几十年中所有卵黄囊瘤患者的总体生存率有所提高，但男性和女性的肿瘤起源部位不同且影响预后。
