Talerman A
Cancer. 1980 Sep 1;46(5):1213-7. doi: 10.1002/1097-0142(19800901)46:5<1213::aid-cncr2820460522>3.0.co;2-z.
The incidence of endodermal sinus tumor (EST) or yolk sac tumor (YST) elements has been studied in two series of testicular germ-cell neoplasms in adults. One series, consisting of 200 germ-cell neoplasms seen from 1053 through 1968, was studied retrospectively, and the other, consisting of 147 cases seen from May 1974 through February 1979, was studied prospectively. Excluding the cases of pure seminoma, EST(YST) elements were found in 21 (28.7%) of 73 cases in the retrospective series and in 27 (44.4%) of 61 cases in the prospective series. The EST(YST) elements were in all cases admixed with other neoplastic germ-cell elements and varied from microscopic foci to being the predominant element within a tumor. The EST(YST) elements were histologically similar to infantile EST(YST) and EST(YST) in other locations. Serum alphafetoprotein (AFP) was determined in the majority of patients in the prospective series, and there was good correlation between the presence of EST(YST) elements within the tumor and elevated levels of AFP. The results of the present study indicate that EST(YST) elements occur quite frequently in testicular germ-cell neoplasms in adults and provide an explanation for the raised levels of serum AFP found in many adults with testicular germ-cell tumors. The results emphasize the importance of a thorough and careful pathologic examination of testicular germ-cell tumors, and the value of AFP as a tumor marker in patients with EST(YST). The results also lend further support to the view that EST(YST) elements found in testicular germ-cell tumors in adults are homologous with infantile EST(YST) and that EST(YST) is a distinctive and specific type of germ-cell neoplasm and should be included as such in the classification of testicular tumors.
在两组成人睾丸生殖细胞肿瘤中研究了内胚窦瘤（EST）或卵黄囊瘤（YST）成分的发生率。一组为回顾性研究，包含1905年至1968年间所见的200例生殖细胞肿瘤；另一组为前瞻性研究，包含1974年5月至1979年2月所见的147例病例。排除纯精原细胞瘤病例后，回顾性研究系列中的73例病例中有21例（28.7%）发现有EST（YST）成分，前瞻性研究系列中的61例病例中有27例（44.4%）发现有EST（YST）成分。在所有病例中，EST（YST）成分均与其他肿瘤性生殖细胞成分混合存在，范围从微小病灶到肿瘤内的主要成分。EST（YST）成分在组织学上与婴儿期EST（YST）及其他部位的EST（YST）相似。前瞻性研究系列中的大多数患者检测了血清甲胎蛋白（AFP），肿瘤内EST（YST）成分的存在与AFP水平升高之间存在良好的相关性。本研究结果表明，EST（YST）成分在成人睾丸生殖细胞肿瘤中相当常见，并为许多成人睾丸生殖细胞肿瘤患者血清AFP水平升高提供了解释。结果强调了对睾丸生殖细胞肿瘤进行全面细致病理检查的重要性，以及AFP作为EST（YST）患者肿瘤标志物的价值。结果还进一步支持了以下观点：成人睾丸生殖细胞肿瘤中发现的EST（YST）成分与婴儿期EST（YST）同源，EST（YST）是一种独特且特定类型的生殖细胞肿瘤，应在睾丸肿瘤分类中如此归类。
