Leblanc Louis, Lagrange François, Lecoanet Pierre, Marçon Baptiste, Eschwege Pascal, Hubert Jacques
1Department of Urology, CHRU Nancy, Nancy, France.
2CNRS UMR 7039 CRAN, Lorraine University, Nancy, France.
Basic Clin Androl. 2018 Jul 9;28:8. doi: 10.1186/s12610-018-0073-3. eCollection 2018.
There are numerous scientific publications on testicular microlithiasis (TML) detected during ultrasound (US) examination. We wished to update the data.
PubMed was used to identify original articles published between 1998 and May 2017 describing the association between TML and testicular tumor. Studies were only included if TML was diagnosed by US. Studies were then classified into subgroups according to the following criteria: asymptomatic, symptomatic, infertility, cryptorchidism, family or personal history of testicular cancer, and "no given reason for US". A Z-Test was used to identify differences within these subgroups. In addition, we identified prospective cohorts of TML patients. Numbers, duration of follow-up, and occurrence of the "testicular tumor" event were recorded for each of them.
One hundred and seventy-five articles were identified, 40 of which were included. Our review has not showed a clear evidence that cryptorchidism associated with TML is a risk factor for testicular tumor. However, there seems to be a correlation between infertility associated with TML and a higher tumor risk. There were not enough studies to confirm a relationship between family or personal history associated with TML and the tumor risk. There was also a correlation with a higher tumor risk for symptomatic associated with TML and "no given reason for US" plus TML groups. However, these groups are assumed to contain bias and caution must be taken regarding conclusions. Regarding the prospective cohort studies, 16 testicular tumors appeared in the follow-up of patients with TML, 13 patients had risk factors.
In cases of TML incidental finding by US with the presence of risk factors (personal history of testicular cancer, testicular atrophy, infertility, cryptorchidism) a consultation with a specialist should be considered. In the absence of risk factors, the occurrence of testicular cancer in patients with TML is similar to the risk of the general population.
关于超声（US）检查中发现的睾丸微石症（TML），有大量的科学出版物。我们希望更新相关数据。
使用PubMed检索1998年至2017年5月间发表的描述TML与睾丸肿瘤之间关联的原始文章。仅纳入通过US诊断为TML的研究。然后根据以下标准将研究分为亚组：无症状、有症状、不育、隐睾症、睾丸癌家族史或个人史，以及“未说明超声检查原因”。使用Z检验来确定这些亚组之间的差异。此外，我们确定了TML患者的前瞻性队列。记录了每组的数量、随访持续时间和“睾丸肿瘤”事件的发生情况。
共识别出175篇文章，其中40篇被纳入。我们的综述未显示与TML相关的隐睾症是睾丸肿瘤危险因素的明确证据。然而，与TML相关的不育与较高的肿瘤风险之间似乎存在相关性。没有足够的研究来证实与TML相关的家族史或个人史与肿瘤风险之间的关系。与TML相关的有症状组以及“未说明超声检查原因”加TML组也与较高的肿瘤风险相关。然而，这些组被认为存在偏差，对结论必须谨慎。关于前瞻性队列研究，在TML患者的随访中出现了16例睾丸肿瘤，13例患者有危险因素。
对于US偶然发现TML且存在危险因素（睾丸癌个人史、睾丸萎缩、不育、隐睾症）的情况，应考虑咨询专科医生。在没有危险因素的情况下，TML患者患睾丸癌的发生率与一般人群的风险相似。
