Giwercman A, von der Maase H, Skakkebaek N E
University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark.
Eur Urol. 1993;23(1):104-10; discussion 111-4.
Despite the high cure rate in men with testicular cancer, efforts should be made to diagnose the disease at the preinvasive stage. The disease, which affects young males, is potentially lethal. Furthermore, testicular neoplasia diagnosed at the stage of CIS can be cured without the negative impact on the life-quality of the survivors, as chemotherapy and other systemic treatment can be avoided. The treatment of choice is orchidectomy if the neoplasia is unilateral, or localized irradiation in bilateral cases. Testicular biopsy performed after puberty is at present the only reliable diagnostic method. Screening for CIS in the contralateral testis should be offered to men with unilateral testicular cancer. Patients with assumed extragonadal germ cell tumour and intersex individuals are also recommended to have a biopsy for CIS. Biopsies should also be considered in adults with maldescended testes and in selected cases of infertility. In the future the techniques of detecting of CIS cells in semen may become refined. In such circumstances, the general male population may be targeted for screening and more cases of testicular cancer could then be prevented.
尽管睾丸癌男性患者的治愈率很高，但仍应努力在癌前阶段诊断该病。这种影响年轻男性的疾病具有潜在致命性。此外，原位癌阶段诊断出的睾丸肿瘤无需进行化疗和其他全身治疗，从而可治愈且不会对幸存者的生活质量产生负面影响。如果肿瘤是单侧的，首选治疗方法是睾丸切除术；双侧病例则采用局部放疗。青春期后进行的睾丸活检是目前唯一可靠的诊断方法。对于单侧睾丸癌男性患者，应进行对侧睾丸原位癌筛查。对于疑似性腺外生殖细胞肿瘤患者和两性畸形个体，也建议进行原位癌活检。成年隐睾患者以及某些不育病例也应考虑进行活检。未来，精液中检测原位癌细胞的技术可能会得到改进。在这种情况下，可能会针对普通男性人群进行筛查，从而预防更多睾丸癌病例。
