Didar GÜRSOY, İlke Evrim SEÇİNTİ, Fatih GOKALP, Sibel HAKVERDİ, Sadık GÖRÜR

Testiküler Seminomatöz ve Nonseminomatöz Germ Hücreli Tümörler: Klinik ve Patolojik Özelliklerinin Karşılaştırılması

Amaç: Bu çalışmada merkezimizde son 10 yılda tanı alan testiküler seminomatöz ve non-seminomatöz germ hücreli tümörlerin klinik ve histopatolojik özelliklerinin farklarını araştırmayı amaçladık. Gereç ve Yöntem: Ocak 2010’dan Mayıs 2020’ye kadar merkezimizde histopatolojik olarak kanıtlanmış testiküler germ hücreli tümör tanısı olan tüm hastalar çalışma kapsamına alındı. Medikal kayıtlar taranarak hastalara ait Hematoksilen-Eozin (H+E) boyalı preparatlar yeniden değerlendirildi. Tümörlerin sınıflandırılmasında ve primer tümörün evresinin belirlenmesinde (pTs) 2016 Dünya Sağlık Örgütü Üriner Sistem ve Erkek Genital Organları Tümörleri Sınıflaması esas alındı. Bulgular: Çalışmamıza dâhil olan olguların 27 tanesi (%51) SEM, 26 tanesi (%49) ise NSE-GHT morfolojisinde idi. SEM grubunda hastaların yaş aralığı 23-55 yıl (minimum-maksimum) arasında değişmekte olup ortanca yaş 33 yıl (IQR=26.0-41.0 yıl) iken NSE-GHT’ler için bu değerler sırasıyla 16-44 yıl ve 28 yıl (IQR=22.75-29.5 yıl) idi. Alt grup ayrımı yapılmaksızın pTs değerlendirmesine göre 21 tümör (%39.6) Evre 1, 31 tümör (%58.5) Evre 2 ve 1 tümör (%1.9) Evre 3 idi. Sonuç: Testis kanserleri genç erkeklerde en sık görülen malignite olup son yıllarda insidansı artış göstermiştir. Komplet kür oranı, erken tanı ve bu tümörlerin yüksek düzeyde kemo- ve radyosensitif olmasından dolayı %100’e yakındır.

Anahtar Kelimeler:

Testis Kanseri, Germ Hücreli Tümör, Seminom, Non-Seminomatöz Germ Hücreli Tümör

Testicular Seminomatous and Nonseminomatous Germ Cell Tumors: Clinical and Pathological Features

Objective: In the present study, it was aimed to investigate the differences between the clinical and histopathological features of testicular seminomatous and non-seminomatous germ cell tumors diagnosed in our center in the recent 10 years. Methods: All the patients in whom diagnosis of testicular germ cell tumor was histologically confirmed in our center between January 2010 and May 2020 were involved in the study. The medical records of the patients were screened and Hematoxylin-Eosin (H+E) stained slides of the patients were re-evaluated. The tumor classification and primary tumor stage determination (pT) were carried out in accordance with the 2016 WHO Classification of Tumors of the Urinary System and Male Genital Organs. Results:The morphology of seminoma (SEM) and non-seminomatous germ cell tumors (NSE-GCTs) were identified in 27 (51%) and 26 (49%) of the study patients, respectively. In the SEM group, patient ages ranged between 23-55 years (min-max) and median age was 33 years (IQR=26.0-41.0) while those values for the NSE-GCT cases were 16-44 years and 28 years (IQR=22.75-29.5), respectively. The evaluation of the pTs without subgroup discrimination demonstrated that 21 (39.6%), 31 (58.5%) and 1 (1.9%) of the tumors were Stage 1, Stage 2 and Stage 3, respectively. Conclusion: Testicular cancers are the most frequently seen malignancy in the young males and its incidence has increased in the recent years. The complete cure rate is approximately 100% thanks to early diagnosis as well as high chemosensitivity and radiosensitivity of these tumors.

Keywords:

Testicular Cancer, Germ Cell Tumor, Seminoma, Non-Seminomatous Germ Cell Tumor,

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Chakrabarti PR, Dosi S, Varma A, Kiyawat P, Khare G, Matreja S. Histopathological trends of testicular neoplasm: An experience over a decade in a tertiary care centre in the Malwa belt of central India. Journal of clinical and diagnostic research. 2016;10(6):16-18. https://doi.org/10.7860/JCDR/2016/18238.8025.
Anjanappa M, Kumar A, Mathews S, Joseph J, Jagathnathkrishna KM, James FV. Testicular seminoma: Are clinical features and treatment outcomes any different in India?. Indian journal of cancer. 2017;54(1):385-387. https://doi.org/10.4103/ijc.IJC_100_17.
Zhang T, Ji L, Liu B, Guan W, Liu Q, Gao Y. Testicular germ cell tumors: a clinicopathological and immunohistochemical analysis of 145 cases. International Journal of Clinical and Experimental Pathology. 2018;11(9):4622-4629.
Li Y, Lu Q, Wang Y, Ma S. Racial differences in testicular cancer in the United States: descriptive epidemiology. BMC cancer. 2020;20(1):284 https://doi.org/ 10.1186/s12885-020-06789-2.
Hassanipour S, Ghorbani M, Derakhshan M, Fouladseresht H, Mohseni S, Abdzadeh E, et al. The incidence of testicular cancer in Iran from 1996 to 2017: A systematic review and meta-analysis. Advances in Human Biology. 2019; 9(1):16-20 https://doi.org/10.4103/AIHB.AIHB_66_18.
Sarıcı H, Telli O, Eroğlu M. Bilateral testicular germ cell tumors. Turkish journal of urology. 2013;39(4):249-252. https://doi.org/10.5152/tud.2013.062.
Ulbright TM, Amin MB, Balzer B, Moch H, Humphrey P, Ulbright T, Reuter, editors. WHO classification of tumours of the urinary system and male genital organs. (4th). IARC Press. (Lyon). 2016.
Sarier M, Tunc M, Ozel E, Duman I, Kaya S, Hoscan MB, et al. Evaluation of histopathologic results of testicular tumors in Antalya: multi center study. 2020;19:64-67. https://doi.org/10.4274/uob.galenos.2019.1412.
Gill MS, Shah SH, Soomro IN, Kayani N, Hasan SH. Morphological pattern of testicular tumors. Journal of Pakistan medical association. 2020; 50(4):110-113.
Trabert B, Chen J, Devesa SS, Bray F, McGlynn KA. International patterns and trends in testicular cancer incidence, overall and by histologic subtype, 1973–2007. Andrology. 2015;3(1):4-12. https://doi.org/10.1111/andr.293.
Lobo J, Costa AL, Vilela-Salgueiro B, Rodrigues A, Guimaraes R, Cantante M, et al. Testicular germ cell tumors: Revisiting a series in light of the new WHO classification and AJCC staging systems, focusing on challenges for pathologists. Human Pathology. 2018;82:113-124. https://doi.org/10.1016/j.humpath.2018.07.016.
Purdue MP, Devesa SS, Sigurdson AJ, McGlynn KA. International patterns and trends in testis cancer incidence. International Journal of Cancer. 2005;115(5):822-827 https://doi.org/10.1002/ijc.20931.
Iqbal J, Kehar SI, Jaffer N, Asad F. Frequency and morphological study of testicular germ cell tumor. The Professional Medical Journal. 2019;26(10):1794-1798. https://doi.org/10.29309/TPMJ/2019.26.10.4144.
Cheng L, Albers P, Berney DM, Feldman DR, Daugaard G, Gilligan T, et al. Testicular cancer. Nature Reviews: Disease Primers. 2018;4(1):29. https://doi.org/10.1038/s41572-018-0029-0.
Williamson SR, Delahunt B, Magi-Galluzzi C, Algaba F, Egevad L, Ulbright TM, et al. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. 2017;70(3):335-346. https://doi.org/10.1111/his.13102.
Ozgun A, Karagoz B, Tuncel T, Emirzeoglu L, Celik S, Bilgi O. Clinicopathological features and survival of young Turkish patients with testicular germ cell tumors. Asian Pacific Journal of Cancer Prevention,. 2013;14(11):6889-6892 https://doi.org/10.7314/apjcp.2013.14.11.688.
Tan G, Azrif M, Shamsul AS, Ho CCK, Praveen S, Goh EH, et al. Clinicopathological Features and Survival of Testicular Tumours in a Southeast Asian University Hospital: A Ten-year. Asian Pacific Journal of Cancer Prevention. 2011;12(10): 2727-2730.
Izegbu MC, Ojo MO, Shittu LA. Clinico-pathological patterns of testicular malignancies in Ilorin, Nigeria-a report of 8 cases. Journal of Cancer research and therapeutics. 2005;1(4):229-231. https://doi.org/10.4103/0973-1482.19598.
O’Sullivan B, Brierley J, Byrd D, Bosman F, Kehoe S, Kossary C, et al. The TNM classification of malignant tumours-towards common understanding and reasonable expectations. Lancet Oncol. 2017;18(7):849-851 https://doi.org/10.1016/S1470-2045(17)30438-2.
Angulo JC, Gonzalez J, Rodriguez N, Núñez C, Rodríguez-Barbero JM, Santana A, et al. Clinicopathological study of regressed testicular tumors (apparent extragonadal germ cell neoplasms). J Urol 2009;182(5):2303-2310 https://doi.org/10.1016/j.juro.2009.07.045.
Gilligan TD, Seidenfeld J, Basch EM, Einhorn LH, Fancher T, Smith DC, et al. American Society of Clinical Oncology Clinical Practice Guideline on uses of serum tumor markers in adult males with germ cell tumors. J Clin Oncol. 2010;28(20):3388-3404 https://doi.org/10.1200/JCO.2009.26.4481.
Stenman UH, Alfthan H, Hotakainen K. Human chorionic gonadotropin in cancer. Clin Biochem. 2004;37(7):549-561. https://doi.org/10.1016/j.clinbiochem.2004.05.008.
Schefer H, Mattmann S, Joss RA. Hereditary persistence of alpha-fetoprotein. Case report and review of the literature. Ann Oncol. 1998;9(6):667-672. https://doi.org/10.1023/a:1008243311122.