Fosså S D, Aass N, Ous S
Tidsskr Nor Laegeforen. 1989 Jan 30;109(3):337-40.
About 130 Norwegian men (15-45 years old) develop testicular cancer each year. Men with a history of undescended testes, atrophic testes and/or fertility problems probably represent a high risk group. Typical symptoms are tumour, harder consistency and discomfort in the testes, low back pain and gynecomastia. Testicular ultrasonography often helps to establish the correct diagnosis. Seminoma is separated from non-seminoma histologically. Adjuvant radiotherapy to the retroperitoneal lymph nodes is the most frequent treatment in seminoma patients with early disease and is combined with chemotherapy in patients with advanced disease. Chemotherapy and surgery are the main therapeutic modalities in non-seminoma patients. In clinical trials a "wait and see" policy is applicable in selected patients with non-seminoma without metastases, provided that frequent follow-up examinations are feasible. Gastrointestinal side effects, alopecia, peripheral neuropathy and azoospermia are the most frequent acute and reversible side effects of treatment of testicular cancer. Post-treatment paternity can be achieved by at least half of the patients who wish to father a child after treatment. The 5-years' survival rate for young patients with testicular cancer is 95%. Young men should perform testicular self-examination regularly. Medical officers in the Armed Forces and doctors at schools and universities and in occupational health should be aware of testicular cancer in young adults with suspicious clinical findings.
挪威每年约有130名15至45岁的男性罹患睾丸癌。有隐睾病史、睾丸萎缩和/或生育问题的男性可能属于高危人群。典型症状包括睾丸出现肿块、质地变硬及不适、下背痛和男子女性型乳房。睾丸超声检查常有助于做出正确诊断。精原细胞瘤与非精原细胞瘤可通过组织学区分。对于早期精原细胞瘤患者，最常用的治疗方法是对腹膜后淋巴结进行辅助放疗，而对于晚期患者则联合化疗。化疗和手术是非精原细胞瘤患者的主要治疗方式。在临床试验中，对于部分无转移的非精原细胞瘤患者，若可行频繁的随访检查，则适用“观察等待”策略。胃肠道副作用、脱发、周围神经病变和无精子症是睾丸癌治疗最常见的急性且可逆的副作用。至少一半希望在治疗后生育子女的患者在治疗后能够实现为人父的愿望。年轻睾丸癌患者的5年生存率为95%。年轻男性应定期进行睾丸自我检查。武装部队的医务人员以及学校、大学和职业健康领域的医生应留意有可疑临床症状的年轻成年人的睾丸癌情况。
