University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark; University Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
J Urol. 2013 Dec;190(6):2074-80. doi: 10.1016/j.juro.2013.06.023. Epub 2013 Jun 14.
We investigated whether semen quality or some easily attainable clinical parameters might be used to estimate the risk of contralateral carcinoma in situ in patients with unilateral testicular germ cell tumors.
A total of 264 Danish patients with testicular germ cell tumor with or without contralateral testicular carcinoma in situ were retrospectively investigated. Clinical data included andrological history, physical examination, testis ultrasonography, semen quality and testis histology. Study groups were compared by univariate linear regression analysis and the chi-square test. Associations between contralateral carcinoma in situ and risk factors were modeled in 2 stages: Bayes rule was used to assess the probability of carcinoma in situ; the terms in Bayes rule were estimated using regression models.
Significant characteristics of patients with contralateral carcinoma in situ were lower sperm concentration, smaller contralateral testis volume, irregular ultrasonic echo pattern of the contralateral testis and younger age. Cutoff values of sperm concentration and testicular volume were defined. However, according to these only a minority of the noncarcinoma in situ cases could potentially have been spared a diagnostic testicular biopsy. Combining information on age and sperm concentration, secondly age and testis volume resulted in models of the estimated contralateral carcinoma in situ risk, from which patients at particular high risk of carcinoma in situ could be identified.
The combined information on sperm concentration, age and contralateral testis volume predict the risk of contralateral carcinoma in situ in patients with unilateral testicular germ cell tumor. The proposed models may facilitate selection of patients with testicular germ cell tumor for contralateral testicular biopsy at the time of orchiectomy if this is not routinely done.
我们研究了精液质量或一些易于获得的临床参数是否可用于估计单侧睾丸生殖细胞肿瘤患者对侧原位癌的风险。
回顾性研究了 264 例丹麦睾丸生殖细胞肿瘤患者（有或无对侧睾丸原位癌）。临床数据包括男科病史、体格检查、睾丸超声、精液质量和睾丸组织学。通过单变量线性回归分析和卡方检验比较研究组。采用贝叶斯规则评估原位癌的概率，并使用回归模型估计贝叶斯规则中的术语，在 2 个阶段对原位癌与危险因素之间的关联进行建模。
具有对侧原位癌的患者具有较低的精子浓度、较小的对侧睾丸体积、对侧睾丸不规则超声回声模式和较年轻的年龄等显著特征。定义了精子浓度和睾丸体积的临界值。然而，根据这些值，只有少数非原位癌病例可能有可能避免进行诊断性睾丸活检。结合年龄和精子浓度的信息，其次是年龄和睾丸体积，可得出对侧原位癌风险的估计模型，从而可以识别出具有特定高原位癌风险的患者。
精子浓度、年龄和对侧睾丸体积的综合信息可预测单侧睾丸生殖细胞肿瘤患者对侧原位癌的风险。如果不是常规进行，则所提出的模型可有助于选择睾丸生殖细胞肿瘤患者在睾丸切除术时进行对侧睾丸活检。
