Kreuser E D, Wellert M, Weidenmaier W, Egghart G, Hautmann R, Hetzel W D, Wolff H
Abteilung Innere Medizin III, Universitätsklinikum Ulm.
Urologe A. 1989 Nov;28(6):344-9.
Although tumor load has proven to be the most relevant prognostic factor in disseminated germ cell tumors (GCT), methods to determine tumor volume for staging have not been studied so far. In a prospective study, we therefore measured the volume of metastases before and during chemotherapy in 27 patients with disseminated GCT. Abdominal tumor volume was calculated using a General Electric CT scan 8800. Total volume was determined by cumulation of 1 cm slices measured by a cursor. Pulmonary volume was calculated by taking each metastasis as a sphere using V = 0.523 x d3, where V = volume and d = diameter. We used linear regression analysis to determine the dependence of tumor markers on volume. Before chemotherapy, the median tumor volume of all patients was 237 (range 4-2690) cm3. The tumor volume was 1-100 cm3 in 30%, 101-500 cm3 in 41%, and over 500 cm3 in 29% of the patients. NED (no evidence of disease) was achieved in 8/8 patients presenting with a small (1-100 cm3) and 9/10 with a moderate (101-500 cm3) tumor volume. In contrast, only 1/8 with advanced tumor load (greater than 500 cm3) achieved NED. While there was a significant correlation between the initial and the residual tumor volume (P = 0.0024, r = 0.72), there was none between the tumor volume and alpha fetoprotein, beta human chorionic gonadotropin, and lactate dehydrogenase. These results suggest that radiological determination of tumor volume is a reproducible and accurate staging method.
尽管肿瘤负荷已被证明是播散性生殖细胞肿瘤（GCT）最相关的预后因素，但迄今为止尚未研究用于分期的肿瘤体积测定方法。因此，在一项前瞻性研究中，我们测量了27例播散性GCT患者化疗前和化疗期间转移灶的体积。腹部肿瘤体积使用通用电气8800型CT扫描计算。总体积通过游标测量的1厘米切片累加确定。肺体积通过将每个转移灶视为球体，使用V = 0.523×d³计算，其中V =体积，d =直径。我们使用线性回归分析来确定肿瘤标志物与体积的相关性。化疗前，所有患者的肿瘤体积中位数为237（范围4 - 2690）cm³。30%的患者肿瘤体积为1 - 100 cm³，41%为101 - 500 cm³，29%超过500 cm³。肿瘤体积小（1 - 100 cm³）的8例患者中有8例达到无疾病证据（NED），肿瘤体积中等（101 - 500 cm³）的10例患者中有9例达到NED。相比之下，肿瘤负荷高（大于500 cm³）的8例患者中只有1例达到NED。虽然初始肿瘤体积与残留肿瘤体积之间存在显著相关性（P = 0.0024，r = 0.72），但肿瘤体积与甲胎蛋白、β人绒毛膜促性腺激素和乳酸脱氢酶之间无相关性。这些结果表明，肿瘤体积的影像学测定是一种可重复且准确的分期方法。
