testicular neoplasms

睾丸肿瘤
  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    背景:生发睾丸肿瘤是20~34岁男性中最常见的恶性肿瘤。即使它们不寻常,在过去的十年中,它们的发病率增加;它们在五年时具有良好的预后和总体生存率,约95%。关于患者的治疗选择存在不同的数据,第二,和第三复发与常规治疗。一些研究描述了使用大剂量化疗与骨髓移植相关的可能益处,结果可变。
    方法:本研究描述了临床结果,临床反应,死亡率,总生存率,一组生发恶性肿瘤患者的无进展生存期为两年,精原细胞瘤与非精原细胞瘤,首先有疾病进展的证据,第二,或第三种常规化疗方案,并在2010年至2021年期间在美国国家癌症研究所接受了高剂量化疗和骨髓移植。
    结果:一项病例系列的回顾性观察性研究表明,57%的三线治疗患者接受了大剂量化疗和骨髓移植,从诊断开始的中位疾病进展时间超过两年。移植后患者出现感染性并发症(71%)。最常见的是发热性中性粒细胞减少症(29%),死亡率为71%(n=5)。无进展生存期2.3个月,总生存期为7.4个月。
    结论:这些结果表明,在这组患者中,与骨髓移植相关的大剂量化疗方案,与其他患者相比,预后较差,并且可能不是这种抢救疗法的最佳候选人。
    BACKGROUND: Germinal testicular tumors are the most common malignant neoplasm in men around 20 to 34 years. Even though they are unusual, they have increased incidence in the last decade; they have an excellent prognosis and overall survival at five years, approximately 95%. Divergent data exists regarding treatment options in patients with first, second, and third relapses with conventional therapy. Some studies describe the possible benefit of using high-dose chemotherapy associated with a bone marrow transplant with variable results.
    METHODS:  The present study describes clinical outcomes, clinical response, mortality, overall survival, and progression-free survival to two years in a group of patients with germinal malignant tumors, seminoma versus non-seminomatous with evidence of progression of the disease at first, second, or third conventional chemotherapy regimens, and who received high dose chemotherapy and bone marrow transplantation at the National Cancer Institute between 2010 and 2021.
    RESULTS: A retrospective observational study of case series showed that 57% of patients in third-line therapy received high-dose chemotherapy and bone marrow transplantation, with progression disease median time from diagnosis more than two years. Patients in the post-graft period presented infectious complications (71%). The most common were febrile neutropenia (29%) with a mortality rate of 71% (n=5), progression-free survival of 2.3 months, and overall survival of 7.4 months.
    CONCLUSIONS:  These results show that in this group of patients, regimens with high-dose chemotherapy associated with bone marrow transplants, have a worse prognosis compared to other cohorts of patients, and may not be the best candidates for this rescue therapy.
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  • 文章类型: Journal Article
    泌尿生殖系统癌症相关死亡率的社会人口统计学差异尚未得到充分研究,特别是在多种癌症类型中。本研究旨在调查性别,种族,以及美国最常见的泌尿生殖系统癌症死亡率的地理差异。
    前列腺死亡率数据,膀胱,肾,和睾丸癌从疾病控制和预防中心(CDC)WONDER数据库在1999年至2020年之间获得。按年份分析了年龄调整后的死亡率(AAMR),性别,种族,城乡地位,和地理区域使用P<0.05的显著性水平。
    总的来说,用于前列腺的AAMR,膀胱,肾癌显著下降,而睾丸癌相关死亡率保持稳定.膀胱和肾癌AAMR男性比女性高3-4倍。前列腺癌死亡率在黑人/非裔美国人中最高,2015年后开始增加。白种人膀胱癌死亡率显著下降,黑人个体,非洲裔美国人,和亚洲人/太平洋岛民,但在美洲印第安人/阿拉斯加原住民中保持稳定。与肾癌相关的死亡率在白人中最高,但在其他种族中显着下降。白人的睾丸癌死亡率显着增加,但黑人和非裔美国人保持稳定。大城市地区的泌尿生殖系统癌症死亡率下降,但在非大城市地区增加(膀胱癌和睾丸癌)或保持稳定(肾癌)。前列腺癌和肾癌死亡率在中西部最高,南方的膀胱癌,西方的睾丸癌.
    在美国泌尿生殖系统癌症的死亡率趋势中存在显著的社会人口统计学差异。这些发现强调了有针对性的干预措施和进一步研究的必要性,以解决这些差异并改善所有受泌尿生殖系统癌症影响的人群的结果。
    UNASSIGNED: Sociodemographic disparities in genitourinary cancer-related mortality have been insufficiently studied, particularly across multiple cancer types. This study aimed to investigate gender, racial, and geographic disparities in mortality rates for the most common genitourinary cancers in the United States.
    UNASSIGNED: Mortality data for prostate, bladder, kidney, and testicular cancers were obtained from the Centers for Disease Control and Prevention (CDC) WONDER database between 1999 and 2020. Age-adjusted mortality rates (AAMRs) were analyzed by year, gender, race, urban-rural status, and geographic region using a significance level of p < 0.05.
    UNASSIGNED: Overall, AAMRs for prostate, bladder, and kidney cancer declined significantly, while testicular cancer-related mortality remained stable. Bladder and kidney cancer AAMRs were 3-4 times higher in males than females. Prostate cancer mortality was highest in black individuals/African Americans and began increasing after 2015. Bladder cancer mortality decreased significantly in White individuals, Black individuals, African Americans, and Asians/Pacific Islanders but remained stable in American Indian/Alaska Natives. Kidney cancer-related mortality was highest in White individuals but declined significantly in other races. Testicular cancer mortality increased significantly in White individuals but remained stable in Black individuals and African Americans. Genitourinary cancer mortality decreased in metropolitan areas but either increased (bladder and testicular cancer) or remained stable (kidney cancer) in non-metropolitan areas. Prostate and kidney cancer mortality was highest in the Midwest, bladder cancer in the South, and testicular cancer in the West.
    UNASSIGNED: Significant sociodemographic disparities exist in the mortality trends of genitourinary cancers in the United States. These findings highlight the need for targeted interventions and further research to address these disparities and improve outcomes for all populations affected by genitourinary cancers.
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  • 文章类型: Case Reports
    背景:脊索瘤,一种罕见的由脊索组织引起的恶性肿瘤,通常发生在脊柱轴。只有少数已发表的原发性肺脊索瘤的报道。在这里,我们介绍了一例原发性肺脊索瘤,并讨论了诊断罕见脊索瘤的重要考虑因素。
    方法:我们报告一例39岁男性原发性肺脊索瘤,有睾丸混合生殖细胞卵黄囊肿瘤和畸胎瘤病史。计算机断层扫描显示左下叶缓慢生长的实性病变。我们对可疑生殖细胞肿瘤肺转移进行了楔形切除术。组织学上,大的圆形或卵圆形细胞与嗜酸性细胞的细胞质被大的细胞包围,颗粒,轻度嗜酸性细胞浆。肿瘤细胞为生唾液。免疫组织化学检查对短尾畸形呈阳性,S-100蛋白,上皮膜抗原,波形蛋白,和细胞角蛋白AE1/AE3,提示肺脊索瘤。睾丸混合生殖细胞肿瘤的重新检查未发现脊索元素。尽管某些区域的短尾染色呈阳性,苏木精和伊红(HE)染色未显示脊索瘤的典型形态特征。肺肿瘤的互补荧光原位杂交(FISH)证实不存在同染色体12p和12p扩增。因此,确定了原发性肺脊索瘤的最终诊断.
    结论:在有睾丸混合生殖细胞肿瘤病史的患者中,肺和睾丸肿瘤的HE和Brachyury染色的组织形态学比较,使用FISH分析肺肿瘤中的12p和12p扩增对于诊断罕见肺脊索瘤至关重要。
    BACKGROUND: Chordoma, a rare malignant tumor arising from notochordal tissue, usually occurs along the spinal axis. Only a few published reports of primary lung chordomas exist. Herein, we present a case of primary lung chordoma and discuss important considerations for diagnosing rare chordomas.
    METHODS: We report a case of primary lung chordoma in a 39-year-old male with a history of testicular mixed germ-cell tumor of yolk sac and teratoma. Computed tomography revealed slow-growing solid lesions in the left lower lobe. We performed wedge resection for suspected germ-cell tumor lung metastasis. Histologically, large round or oval cells with eosinophilic cytoplasm were surrounded by large cells with granular, lightly eosinophilic cytoplasm. Tumor cells were physaliphorous. Immunohistochemistry was positive for brachyury, S-100 protein, epithelial membrane antigen, vimentin, and cytokeratin AE1/AE3, suggesting pulmonary chordoma. Re-examination of the testicular mixed germ-cell tumor revealed no notochordal elements. Although some areas were positive for brachyury staining, hematoxylin and eosin (HE) staining did not show morphological features typical of chordoma. Complementary fluorescence in situ hybridization (FISH) of the lung tumor confirmed the absence of isochromosome 12p and 12p amplification. Thus, a final diagnosis of primary lung chordoma was established.
    CONCLUSIONS: In patients with a history of testicular mixed germ cell tumors, comparison of histomorphology using HE and Brachyury staining of lung and testicular tumors, and analyzing isochromosome 12p and 12p amplification in lung tumors using FISH is pivotal for the diagnosis of rare lung chordomas.
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    文章类型: Journal Article
    Testicular tumors are rarely reported in rabbits. In this case study, a 4-year-old Holland lop rabbit, previously diagnosed with unilateral cryptorchidism, was presented because of enlargement of the descended testis. The rabbit was clinically normal. Following unilateral orchiectomy and scrotal ablation, histopathological analysis revealed 2 distinct types of testicular tumor in the descended testis: a granular cell tumor and a seminoma. To the best of the author\'s knowledge, this is the first documented report of simultaneous testicular tumors in the testis of a rabbit with unilateral cryptorchidism.
    Tumeur à cellules granulaires et séminome simultanés dans le testicule descendu d’un lapin cryptorchideLes tumeurs testiculaires sont rarement rapportées chez le lapin. Dans cette étude de cas, un lapin Holland Lop de 4 ans, précédemment diagnostiqué avec une cryptorchidie unilatérale, a été présenté en raison d’une hypertrophie du testicule descendu. Le lapin était cliniquement normal. Après orchidectomie unilatérale et ablation scrotale, l’analyse histopathologique a révélé 2 types distincts de tumeur testiculaire dans le testicule descendu : une tumeur à cellules granuleuses et un séminome. À la connaissance de l’auteur, il s’agit du premier rapport documenté de tumeurs testiculaires simultanées dans le testicule d’un lapin atteint de cryptorchidie unilatérale.(Traduit par Dr Serge Messier).
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  • 文章类型: Case Reports
    背景:恶性实体瘤的睾丸转移极为罕见。通常在睾丸标本的尸检或病理检查中偶然发现。因此,我们认为有必要报告患者的结肠癌睾丸转移病例。
    方法:我们报告了一名61岁的汉族男性患者,他在我们的诊所就诊,右睾丸进行性无痛性肿胀2年。正电子发射断层扫描-计算机断层扫描显示右睾丸中18F-氟代脱氧葡萄糖代谢增加,可能是由于远处转移。他以前的病史表明,他在4年前接受了腹腔镜辅助右半结肠切除术治疗升结肠癌。考虑到升结肠癌转移到右睾丸,我们通过腹股沟入路进行了右睾丸根治性切除术.术后组织学检查为肠转移性腺癌。
    结论:结肠癌转移到睾丸并不常见。该肿瘤的临床和影像学表现是非特异性的,所以诊断依赖于术后病理。如果发现睾丸转移,应遵循晚期结肠癌的治疗原则。
    BACKGROUND: Testicular metastasis from malignant solid tumors is extremely rare. It is usually found by chance during autopsy or pathological examination of testicular specimens. Therefore, we consider it necessary to report our patient\'s case of testicular metastasis from colon cancer.
    METHODS: We report a 61-year-old Han Chinese male patient who presented to our clinic with progressive painless swelling of the right testicle for 2 years. Positron emission tomography-computed tomography scans showed increased 18F-fluorodeoxyglucose metabolism in the right testicle, possibly owing to distant metastasis. His previous medical history suggested that he had undergone laparoscopic-assisted right hemicolectomy for ascending colon cancer 4 years ago. Considering the ascending colon cancer metastasis to the right testicle, we performed a right radical testicular resection through an inguinal approach. Postoperative histological examination showed intestinal metastatic adenocarcinoma.
    CONCLUSIONS: Colon cancer metastasis to the testes is uncommon. The clinical and imaging manifestations of this tumor are nonspecific, so the diagnosis relies on postoperative pathology. If testicular metastasis is found, treatment principles for advanced colon cancer should be followed.
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  • 文章类型: Case Reports
    背景:原发性睾丸淋巴瘤(PTL)相对罕见。对侧睾丸是PTL复发的常见部位;因此,一旦达到完全缓解,对侧睾丸进行放射治疗(RT)以防止复发。
    方法:一名76岁男性被诊断患有PTL并接受如上所述的RT。然而,尽管实现并保持完全缓解,经组织活检诊断为弥漫性大B细胞淋巴瘤的包块在预防性RT后6.5年在龟头出现。我们使用从两个组织病理学标本中提取的DNA的下一代测序,通过基因组分析,研究了龟头阴茎淋巴瘤是PTL复发还是新的恶性肿瘤。
    结论:我们在四个体细胞基因中发现了相同的变异等位基因分数(MYD88,IL7R,BLNK,和FLT3)在相似的频率下,这表明阴部阴茎淋巴瘤与PTL的起源相同。据我们所知,这是首例龟头PTL复发的病例报告.
    BACKGROUND: Primary testicular lymphoma (PTL) is relatively rare. The contralateral testis is a common site of PTL relapse; therefore, once complete remission is achieved, radiation therapy (RT) is administered to the contralateral testis to prevent relapse.
    METHODS: A 76-year-old man was diagnosed with PTL and received RT as described above. However, despite achieving and maintaining complete remission, a mass diagnosed as diffuse large B-cell lymphoma by tissue biopsy developed in the glans penis 6.5 years after prophylactic RT. We investigated whether the glans penile lymphoma was PTL relapse or a new malignancy by genomic analysis using next-generation sequencing of DNA extracted from two histopathological specimens.
    CONCLUSIONS: We found the same variant allele fraction in four somatic genes (MYD88, IL7R, BLNK, and FLT3) at similar frequencies, indicating that the glans penile lymphoma had the same origin as the PTL. To the best of our knowledge, this is the first case report of PTL relapse in the glans penis.
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  • 文章类型: Journal Article
    睾丸癌(TCA)是一种罕见但有影响的恶性肿瘤,主要影响年轻男性。了解TCA的死亡率对于改善预防和治疗策略以降低患者死亡风险至关重要。我们按地点(5个国家)获得了TCA死亡率数据,年龄(20-79岁),和年份(1990-2019)来自2019年全球疾病负担研究。使用年龄-周期-队列模型来估计净漂移,局部漂移,年龄影响,时期和队列效应。2019年,TCA的全球死亡率上升至10842(95%UI9961,11902),与1990年相比增长了50.08%。2019年TCA的全年龄段死亡率从中国的0.17/100,000(95%UI0.13,0.20)上升到俄罗斯联邦的0.48/100,000(95%UI0.38,0.59),而2019年年龄标准化死亡率最高的是南非0.47/100,000(95%UI0.42,0.53),最低的是中国0.16/100,000(95%UI0.13,0.19)。中国人口老龄化使死亡模式向老年人转变,在俄罗斯联邦,年轻人主要受到死亡分布的影响。为了解决金砖国家不同的TCA死亡率进步,我们提出了一种情境适应性和资源意识的方法来优先考虑TCA预防。根据情境多样性定制策略,包括政策框架,人力资源,和财政能力,将增强针对性干预措施和降低TCA死亡率的有效性。
    Testicular cancer (TCa) is a rare but impactful malignancy that primarily affects young men. Understanding the mortality rate of TCa is crucial for improving prevention and treatment strategies to reduce the risk of death among patients. We obtained TCa mortality data by place (5 countries), age (20-79 years), and year (1990-2019) from the Global Burden of Disease Study 2019. Age-period-cohort model was used to estimate the net drift, local drift, age effects, period and cohort effects. In 2019, the global mortality of TCa increased to 10842 (95% UI 9961, 11902), with an increase of 50.08% compared to 1990.The all-age mortality rate for TCa in 2019 increased from 0.17/100,000 (95% UI 0.13, 0.20) in China to 0.48/100,000 (95% UI 0.38, 0.59) in Russian Federation, whereas the age-standardized mortality rate in 2019 was highest in the South Africa 0.47/100,000 (95% UI 0.42, 0.53) and lowest in the China 0.16/100,000 (95% UI 0.13, 0.19). China\'s aging population shifts mortality patterns towards the elderly, while in Russian Federation, young individuals are primarily affected by the distribution of deaths. To address divergent TCa mortality advancements in BRICS countries, we propose a contextually adaptive and resource-conscious approach to prioritize TCa prevention. Tailoring strategies to contextual diversity, including policy frameworks, human resources, and financial capacities, will enhance targeted interventions and effectiveness in reducing TCa mortality.
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  • 文章类型: Journal Article
    背景:睾丸生殖细胞肿瘤(TGCT)表现出多种生物学和病理学特征,分为两种主要类型,精原细胞瘤和非精原细胞生殖细胞肿瘤(NSGCT)。CD44是一种细胞表面受体,在恶性肿瘤中高度表达,并与影响细胞-基质相互作用和细胞信号传导的肿瘤发生有关。
    结果:这里,我们检测了CD44在肿瘤细胞系和患者材料中的表达。我们发现与正常组织相比,CD44在TGCT中过度表达。在71个组织标本中的免疫组织化学染色显示CD44在一些患者中的表达增加,而CD44在正常组织中不存在。在精原细胞瘤中,高百分比的肿瘤和基质细胞显示CD44的细胞质和/或细胞表面染色,并且在某些情况下发现肿瘤基质中CD44的染色增加。CD44在肿瘤细胞或基质成分中的表达增加与肿瘤大小有关。淋巴结转移,血管/淋巴侵入,和疾病阶段仅在精原细胞瘤。TGCT中CD44的基质表达增加与血管生成呈正相关。
    结论:CD44在精原细胞瘤和NSGCT中可能表现出不同的生物学功能。CD44在肿瘤细胞以及肿瘤基质中的表达促进了精原细胞瘤的侵袭性表型,应在疾病治疗中予以考虑。
    BACKGROUND: Testicular germ cell tumors (TGCTs) exhibit diverse biological and pathological features and are divided in two main types, seminomas and nonseminomatous germ cell tumors (NSGCTs). CD44 is a cell surface receptor, which is highly expressed in malignancies and is implicated in tumorigenesis affecting cell-matrix interactions and cell signaling.
    RESULTS: Here, we examined the expression of CD44 in tumor cell lines and in patients\' material. We found that CD44 is over-expressed in TGCTs compared to normal tissues. Immunohistochemical staining in 71 tissue specimens demonstrated increased expression of CD44 in some patients, whereas CD44 was absent in normal tissue. In seminomas, a high percentage of tumor and stromal cells showed cytoplasmic and/or cell surface staining for CD44 as well as increased staining for CD44 in the tumor stroma was found in some cases. The increased expression of CD44 either in tumor cells or in stromal components was associated with tumor size, nodal metastasis, vascular/lymphatic invasion, and disease stage only in seminomas. The increased stromal expression of CD44 in TGCTs was positively associated with angiogenesis.
    CONCLUSIONS: CD44 may exhibit diverse biological functions in seminomas and NSGCTs. The expression of CD44 in tumor cells as well as in tumor stroma fosters an aggressive phenotype in seminomas and should be considered in disease treatment.
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  • 文章类型: Journal Article
    背景:观察性研究调查了恶性贫血(PA)与癌症之间的关系。然而,除了胃癌,结果大多是矛盾的。这项研究的目的是通过双向双样本孟德尔随机(MR)分析来研究PA与癌症之间的潜在因果关系。
    方法:欧洲样本FinnGen项目提供了PA和20种位点特异性癌症的遗传汇总数据。这种双向双样本MR设计主要使用逆方差加权(IVW)方法来评估PA与癌症风险之间的因果关系。进行Benjamini-Hochberg校正以减少由多次测试引起的偏差。
    结果:我们的研究表明PA与胃癌之间存在因果关系,前列腺癌,睾丸癌和皮肤恶性黑色素瘤,前列腺癌或胃癌与PA之间存在反向因果关系(P<0.05)。在Benjamini-Hochberg校正测试之后,PA与胃癌或前列腺癌之间仍然存在因果关系(P'<0.05),而PA与睾丸癌和皮肤恶性黑色素瘤之间仅有隐含的因果关系(P>0.05)。胃癌与PA之间仍存在反向因果关系(P<0.05)。而前列腺癌显示出隐含的反向因果关系(P>0.05)。此外,MR-Egger和MR-PRESSO测试未显示明显的水平多效性。
    结论:PA可能与睾丸癌遗传相关,前列腺癌,胃癌,皮肤恶性黑色素瘤.
    BACKGROUND: Observational study investigated the association between pernicious anemia (PA) and cancers. However, with the exception of gastric cancer, the results are mostly contradictory. The purpose of this study was to investigate the potential causal relationship between PA and cancers through bidirectional two-sample Mendelian randomized (MR) analysis.
    METHODS: The European sample FinnGen project provided the genetic summary data for PA and 20 site-specific cancers. This bidirectional two-sample MR design mainly used the inverse variance weighting (IVW) method to evaluate the causal relationship between PA and cancer risk. Benjamini-Hochberg correction was performed to reduce the bias caused by multiple tests.
    RESULTS: Our study shows that there was a causal relationship between PA and gastric cancer, prostate cancer, testicular cancer and malignant melanoma of skin, and there was a reverse causal relationship between prostate cancer or gastric cancer and PA (P < 0.05). After Benjamini-Hochberg correction test, there was still a causal correlation between PA and gastric or prostate cancer (P\' < 0.05), while there was only an implied causal association between PA and testicular cancer and malignant melanoma of skin (P\'> 0.05). There was still a reverse causal relationship between gastric cancer and PA (P\'< 0.05), while prostate cancer shows an implied reverse causal relationship(P\'> 0.05). In addition, MR-Egger and MR-PRESSO tests showed no significant horizontal pleiotropy.
    CONCLUSIONS: PA may be genetically associated with testicular cancer, prostate cancer, gastric cancer, and malignant melanoma of skin.
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