摘要
目的探讨睾丸生殖细胞瘤的临床特征及影响其术后复发的风险因素。方法分析2015年1月至2021年12月就诊于河南省肿瘤医院的睾丸肿瘤患者共计69例,其中经病理证实生殖细胞肿瘤57例。采用非参数检验或χ^(2)检验比较精原与非精原细胞瘤的临床特征差异。通过COX回归分析影响睾丸生殖细胞瘤复发的风险因素,同时构建预测模型并计算模型的C-index指数。结果睾丸精原与非精原细胞瘤的患者在年龄(Z=-3.254,P<0.05)和肿瘤T分期(χ^(2)=4.613,P<0.05)方面存在差异;而在肿瘤体积、肿瘤侧别、淋巴转移及复发方面无统计学意义(P>0.05)。COX回归提示睾丸非精原细胞瘤患者更容易出现复发[风险比(HR)=16.389,95%可信区间(CI):2.946~91.164,P<0.05];肿瘤的体积越大,其术后复发的风险越高(HR=1.008,95%CI:1.001~1.016,P<0.05);治疗前存在淋巴结转移的患者复发的几率相对较高(HR=33.524,95%CI:5.226~215.031,P<0.01);右侧睾丸生殖细胞瘤患者相对不容易出现复发(HR=0.170,95%CI:0.040~0.724,P<0.05)。构建预测模型的C-index指数为0.879(95%CI:0.793~0.965)。结论患者的年龄和肿瘤T分期在精原与非精原细胞瘤间存在显著差异。肿瘤体积、病理类型、淋巴结受侵以及肿瘤的侧别都是影响睾丸生殖细胞瘤术后复发的独立因素。
Objective To investigate the clinical characteristics of testicular germ cell tumor and the risk factors affecting the recurrence.Methods A total of 69 patients with testicular tumors who attended Henan Provincial Cancer Hospital from 2015.1 to 2021.12 were retrospectively analyzed,including 57 cases of pathologically confirmed germ cell tumor.Differences in clinical characteristics between seminoma and non-seminoma were compared using non-parametric tests or chi-square test.COX regression was utilized to analyze the risk factors affecting the recurrence of testicular germ cell tumor.The results of the study were used to construct a prediction model and calculate the C-index.Results Patients with seminoma and non-seminoma were statistically different in age(Z=-3.254,P<0.05)and tumor T-stage(χ^(2)=4.613,P<0.05),while no statistically significant differences existed in tumor volume,tumor side,lymphatic metastasis,and postoperative recurrence(P>0.05);Patients with non-seminoma[hazard ratio(HR)=16.389,95%confidence interval(CI):2.946-91.164,P<0.05]and large tumor size(HR=1.008,95%CI:1.001-1.016,P<0.05)were more likely to have recurrence.Patients with lymph node metastasis had a relatively higher chance of recurrence(HR=33.524,95%CI:5.226-215.031,P<0.01),while patients with right testicular tumor was less likely to have recurrence(HR=0.170,95%CI:0.040-0.724,P<0.05).The C-index for the prediction model was 0.879(95%CI:0.793-0.965).Conclusion Patients’age and T-stage were significantly difference between seminoma and non-seminoma.Tumor volume,type of pathology,lymph node invasion,and tumor side were independent risk factors for recurrence of testicular germ cell tumor.
作者
李靖
田沛
任君凯
何朝宏
连振鹏
Li Jing;Tian Pei;Ren Junkai;He Chaohong;Lian Zhenpeng(Department of Urology,Affiliated Cancer Hospital of Zhengzhou University,Henan Cancer Hospital,Zhengzhou 450008,China)
出处
《中华实验外科杂志》
CAS
北大核心
2023年第3期559-562,共4页
Chinese Journal of Experimental Surgery
基金
河南省科技攻关项目(222102310629)
河南省医学科技攻关项目(LHGJ20220193)。
