Yaegashi Hiroshi, Nohara Takahiro, Shigehara Kazuyoshi, Izumi Kouji, Kadono Yoshifumi, Makino Tomoyuki, Yamashita Kaname, Ohtsubo Koushiro, Ikeda Hiroko, Mizokami Atsushi
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Department of Urology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Cancer Diagn Progn. 2022 May 3;2(3):352-359. doi: 10.21873/cdp.10116. eCollection 2022 May-Jun.
BACKGROUND/AIM: Primary mediastinal non-seminomatous germ cell tumors (PMNSGCTs) are occasionally complicated by a hematologic malignancy, as with somatic-type malignant tumors called germ cell tumors with somatic-type malignancy (GCTSTM) and are known to have a poor prognosis.
Data obtained between September 1997 and February 2020 for patients with mediastinal germ cell tumor at our institution were retrospectively analyzed. Key outcome measures included survival rates and the clinical features of non-seminoma cases.
Of 16 patients, 9 had pure seminoma, and 7 had non-seminoma. At the median follow-up of 56.2 months, the 5-year survival rate was significantly higher in patients with seminoma (100%) than in those with non-seminoma (37%) (log-rank test, p=0.0153). Regarding PMNSGCT, two patients evolved into GCTSTM and three had concomitant hematological malignancies.
Patients with PMNSGCTs, GCTSTM complications, and hematologic malignancies showed poor survival, suggesting the need for the development of treatment strategies.
背景/目的：原发性纵隔非精原细胞性生殖细胞肿瘤（PMNSGCTs）偶尔会并发血液系统恶性肿瘤，就像伴有体细胞型恶性肿瘤的生殖细胞肿瘤（GCTSTM）这种体细胞型恶性肿瘤一样，并且已知其预后较差。
对1997年9月至2020年2月期间在我们机构就诊的纵隔生殖细胞肿瘤患者的数据进行回顾性分析。主要结局指标包括生存率和非精原细胞瘤病例的临床特征。
16例患者中，9例为纯精原细胞瘤，7例为非精原细胞瘤。在中位随访56.2个月时，精原细胞瘤患者的5年生存率（100%）显著高于非精原细胞瘤患者（37%）（对数秩检验，p = 0.0153）。关于PMNSGCT，2例患者发展为GCTSTM，3例伴有血液系统恶性肿瘤。
患有PMNSGCTs、GCTSTM并发症和血液系统恶性肿瘤的患者生存率较差，这表明需要制定治疗策略。
