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目的有报道睾丸微石症(TM)与睾丸癌有关,因此有人提倡对TM病人进行超声监测。本研究的目的在于评价该监测的依据。方法通过回顾正式文献确定队列研究对象,包括15例病人至少随访24个月。单位审核确定的研究共同进行汇集分析,评价监测期间新发癌的发病率。结果通过文献复习确定8项研究。我们机构审核包括进行阴囊超声检查的2656例男性病人。其中51例(1.92%)被确诊为TM,无一例发生睾丸癌(平均随访时间33.3个月)。在组合人群的389例中4例发生睾丸癌,其中3例有其他危险因素,只有1例在随访中发生睾丸癌(95%CI:0.05%～1.45%)。结论对无其他危险因素的TM病人,超声监测无益。如果有其他危险因素(既往睾丸癌,睾丸下降不良或睾丸萎缩病史),则可进行监测;应鼓励每月进行自我检查,并进行超声和正式的年度监测。
Purpose It has been reported that testicular microlithiasis (TM) is associated with testicular cancer, and therefore some have advocated ultrasound monitoring of TM patients. The purpose of this study is to evaluate the basis of this monitoring. Methods The cohort was identified by reviewing the available literature, including 15 patients who were followed up for at least 24 months. The units identified by the review together to conduct pooled analysis to evaluate the incidence of newcancer cancer during the monitoring period. Results Eight studies were identified through literature review. Our agency reviewed 2656 male patients who underwent scrotal ultrasonography. Fifty-one patients (1.92%) were diagnosed with TM and none of them had testicular cancer (mean follow-up period 33.3 months). Testicular cancer occurred in 4 of 389 patients in the combined population, with 3 other risk factors and only 1 patient having testicular cancer (95% CI: 0.05% to 1.45%) at follow-up. Conclusion For TM patients without other risk factors, ultrasound monitoring is not helpful. Surveillance can be performed if there are other risk factors (previous history of testicular cancer, testicular descent, or testicular atrophy); monthly self-examination should be encouraged with ultrasound and formal annual monitoring.