[Testicular tumors: association between preoperative clinical, radiological and immuno-serological factors, and histology and stage].
OBJECTIVE
To evaluate and quantify the association between clinical, ultrasound and immunoserological data and histologic type and stage of testicular tumors.


METHODS
We analyze a cohort of 80 patients who underwent orchiectomy for testicular neoplasia. Mean patient age was 30.4 years. Past medical history, first symptoms, time from first symptom to operation, physical examination and ultrasound data, and preoperative serum levels of alpha-fetoprotein and beta HCG were retrospectively collected.


RESULTS
Patients with non seminomatous germ cell tumor (NSGCT) had a significantly lower mean age (23.7 yr.) than patients with pure seminoma (41.3 yr.), and these latter a significantly lower age than patients with non germinal tumors (50.7 yr.). Initial presentation with general malaise or lumbar pain increased 2.56 times the relative risk of having a tumor in advanced stage (higher than stage I) . Presence of gynecomastia increased 16.5 times the relative risk of having a non germ cell tumor, due to the inclusion of Leydig's tumors in this group. Detection of heterogeneous nodules by ultrasound increased 4.5 times the risk of having a non seminomatous germ cell tumor. Preoperative elevation of alpha-fetoprotein ruled out the existence of seminoma and non germ cell tumor; whereas preoperative elevation of beta HCG increased 3.21 times the risk of having a non seminomatous germ cell tumor. No significant association was shown between preoperative tumor markers and tumor stage.


CONCLUSIONS
The existence of gynecomastia, age, detection of heterogeneous nodules on ultrasound, and preoperative alpha-fetoprotein and beta HCG are relevant data in relation to histological type of tumor. Lumbar pain or malaise are clinical data associated with tumor stage.
Servicio de Urología, Hospital Central de la Defensa, Madrid, España.
Ramón
R
Diz Rodráguez
Miguel
M
Vírseda Chamorro
Pablo
P
Quijano Barroso
Carlos
C
Alpuente Román
Domingo
D
Sáez Benito
Pedro
P
Paños Lozano
D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy; D011859:Radiography; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D000509:alpha-Fetoproteins / Q000032:analysis
D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins