Detailed pathologic analysis on the co-occurrence of non-seminomatous germ cell tumor subtypes in matched orchiectomy and retroperitoneal lymph node dissections
Detailed pathologic analysis on the co-occurrence of non-seminomatous germ cell tumor subtypes in matched orchiectomy and retroperitoneal lymph node dissections
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DOI：
10.1007/s12032-018-1090-y
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发表时间：
2018-03-01
期刊：
影响因子：
3.4
通讯作者：
Mehra, Rohit
中科院分区：
文献类型：
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作者：
Spratt, Daniel E.;Suresh, Krithika;Mehra, Rohit
生殖细胞肿瘤（GCT）成分在非腺瘤性生殖细胞肿瘤（NSGCT）睾丸切除术标本中的共同出现频率及其与随后腹膜后淋巴结清扫（RPLND）标本中组织学结果的相关性尚未得到很好的表征。该研究的目的是报告NSGCT睾丸切除术和RPLND样本的第一个详细的临床病理学分析，以确定GCT成分共同出现的可能性和一致性。分析了1988年至2012年期间在一家三级医疗中心接受睾丸切除术和RPLND治疗的118例连续NSGCT患者。对睾丸切除术和RPLND标本内和之间的GCT成分的共现可能性和一致性进行统计分析。胚胎癌是睾丸切除术标本中最常见的成分，睾丸切除术GCT成分之间存在多种显著相关性;睾丸癌与胚胎癌发生率较低（OR 0.29 [95%可信区间（CI）0.11-0.75]; p < 0.01），畸胎瘤更常发生于绒毛膜癌（OR 9.64 [95%CI 1.22-76.12]; p = 0.01）。在多变量分析中，睾丸切除术标本中存在畸胎瘤预测远处转移增加4倍（HR 4.92 [1.14-18.9]; p = 0.02）。在RPLND标本中，胚胎癌和畸胎瘤之间的共同出现唯一显著相关性（OR 0.01 [95%CI 0-0.07]; p < 0.001），其中它们共同出现的可能性显著较低。我们的研究结果受到其回顾性性质的限制。睾丸切除标本中GCT成分的共同出现似乎不是一个完全随机的过程。然而，在匹配的睾丸切除术和RPLND样本中GCT成分的发生之间存在较少的一致性和更多的随机性。在这份报告中，我们研究了在匹配的睾丸切除术和RPLND病理标本中不同GCT成分的共同出现，并表明共同出现不是一个完全随机的过程。
The frequency of co-occurrence between germ cell tumor (GCT) components in non-seminomatous germ cell tumor (NSGCT) orchiectomy specimens and their correlation with histologic findings in subsequent retroperitoneal lymph node dissection (RPLND) specimens have not been well characterized. The objective of the study was to report the first detailed clinicopathologic analysis of NSGCT orchiectomy and RPLND samples to determine the likelihood and agreement of the co-occurrence of GCT components. A total of 118 consecutive patients with NSGCT treated between 1988 and 2012 who underwent both orchiectomy and RPLND at a single academic tertiary care center were analyzed. Statistical analysis of co-occurrence likelihood and agreement of GCT components was performed, both within and between orchiectomy and RPLND specimens. Embryonal carcinoma was the most frequent component present in orchiectomy specimens, and there were multiple significant associations between orchiectomy GCT components; seminoma occurred less frequently with embryonal carcinoma (OR 0.29 [95% confidence interval (CI) 0.11-0.75]; p < 0.01), and teratoma more frequently occurred with choriocarcinoma (OR 9.64 [95% CI 1.22-76.12]; p = 0.01). Presence of teratoma in the orchiectomy specimen predicted for a fourfold increase in distant metastasis on multivariate analysis (HR 4.92 [1.14-18.9]; p = 0.02). The only significant association of co-occurrence in the RPLND specimen was between embryonal carcinoma and teratoma (OR 0.01 [95% CI 0-0.07]; p < 0.001), where it was significantly less likely for them to occur together. Our findings are limited by their retrospective nature. The co-occurrence of GCT components within orchiectomy specimens does not appear to be a completely random process. However, there is less agreement and more randomness between the occurrence of the GCT components in matched orchiectomy and RPLND samples. In this report, we look at the co-occurrence of different GCT components within matched orchiectomy and RPLND pathology specimens and show that co-occurrence is not a completely random process.