治疗小儿睾丸卵黄囊瘤25年的临床回顾  

Retrospective review of testical yolk sac tumors during 25 years' period

作　　者：阮双岁[1] 陆毅群[1] 葛琳娟[1] 高解春[1] 傅阳[1] 金百祥[1] 

机构地区：[1]上海医科大学儿科医院外科,200032

出　　处：《中华小儿外科杂志》2000年第6期336-338,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　回顾 2 5年治疗小儿睾丸卵黄囊瘤的疗效 ,以探讨睾丸卵黄囊瘤的合理治疗方案。方法　 43例小儿睾丸卵黄囊瘤均施行根治性高位精索睾丸切除术。 2 7例同时或分期施行腹膜后淋巴结清扫术。 16例甲胎蛋白 (AFP)升高。随访 32例 ,存活 2 9例 ,其中淋巴结清扫 16例 ,未清扫13例。结果　腹膜后淋巴结清扫组存活率与未清扫组差异无显著性意义 ,术前AFP阳性的存活率与AFP阴性者也差异无显著性意义。结论　对Ⅰ期小儿睾丸卵黄囊瘤不进行腹膜后淋巴结清扫。术后 3周血清AFP仍增高者 ,结合CT或B超明确有淋巴结转移者 ,才有腹膜后淋巴结清扫的指征。术后化疗Ⅰ期患儿选用AD方案 ,Ⅱ期、Ⅲ期选用PVB方案。Objective To discuss a proper treatment protocol for testicle yolk sac tumors. Methods The outcomes of 43 children with testicle Yolk sac tumors of the past 25 years were reviewed. All cases were underwent radical high level spermatectomy and orchiectomy, and 27 of them were performed on retroperitoneal lymphadenectomy simultaneously or in stage. The AFP was increased in 16 cases. The follow up results showed that 29 were still alive. There were no difference among patients with retroperitoneal lymphadenectomy or without. Conclusions Patients with testicle yolk sac tumors in stage I needn't retroperitoneal lymphadenectomy. It is indicated in cases with a sustained elevation of AFP, and confirmation of retroperitoneal lymph node metastasis by ultrasound or CT. For chemotherapy, AD protocol is used in stage 1 of yolk sac tumors, and PVB protocol is adopted in stage II or stage III.

关 键 词：卵黄囊瘤 睾丸肿瘤 淋巴结切除 儿童 治疗 

分 类 号：R737.21[医药卫生—肿瘤]