术前良恶性鉴别在睾丸肿瘤手术决策中的作用---单中心121例睾丸肿瘤患者的数据分析

The role of preoperative differentiation in surgical decision-making for testicular tumors: a single-center data analysis of 121 testicular tumor patients

摘要

目的 探讨术前评估及术中冰冻病理在筛选可行保留睾丸手术患者中的临床价值，为减少睾丸良性肿瘤患者接受不必要的睾丸根治性切除术提供参考。方法 回顾性分析2021年1月-2025年9月于西安交通大学第一附属医院泌尿外科接受手术治疗的121例睾丸肿瘤患者的临床资料。收集患者的基本资料、术前影像学及血清肿瘤标志物的检查结果、手术方式、术中冰冻及术后病理结果，并随访睾丸肿瘤剜除术后睾丸体积变化。结果 纳入的121患者中105例行睾丸根治性切除术，术后病理结果显示恶性91例、良性14例；16例行睾丸肿瘤剜除术，术后病理结果均为良性。良性病变占同期所有睾丸肿瘤患者的24.79%（30/121）。在接受睾丸肿瘤剜除术的患者中，术中冰冻病理结果与术后病理结果均一致。结论 术前对睾丸肿瘤进行良恶性鉴别诊断对手术方式的选择具有重要意义。对于术前检查提示良性可能的患者，在充分评估的基础上，采用睾丸肿瘤剜除术联合术中冰冻病理检查，有助于避免不必要的睾丸切除。

Abstract

Objective To explore the clinical value of preoperative assessment and intraoperative frozen section pathology in screening patients suitable for testicular preservation surgery, so as to provide reference for reducing unnecessary radical orchiectomy in patients with benign testicular tumors. Methods A retrospective analysis was conducted on 121 patients who underwent surgical treatment for testicular tumors in the First Affiliated Hospital of Xi'an Jiaotong University during Jan. 2021 and Sep. 2025. Data were collected, including demographic information, preoperative imaging, serum tumor markers, surgical procedures, intraoperative frozen section, postoperative pathology, and postoperative testicular volume changes. Results Among the 121 patients, 105 underwent radical orchiectomy, with 91 malignant and 14 benign cases confirmed by postoperative pathology; 16 received testicular tumor enucleation, all confirmed as benign. Benign lesions accounted for 24.79% (30/121) of all cases. In patients undergoing tumor enucleation, intraoperative frozen section results were fully consistent with final pathological findings. Conclusion Preoperative differentiation between benign and malignant testicular tumors is crucial for selecting the appropriate surgical approach. For patients with preoperative findings suggesting benign lesions, testicular tumor enucleation combined with intraoperative frozen section can achieve precise treatment while maximizing testicular preservation.

关键词

睾丸肿瘤 / 睾丸保留手术 / 睾丸肿瘤剜除术 / 睾丸根治性切除术

Key words

testicular tumor / testis-sparing surgery / testicular tumor enucleation / radical orchiectomy

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