How to correctly diagnose testicular cancer

Testicular cancer is a disease that occurs in the testicular tissue of men. The cause of the disease is uncertain, so it is difficult to treat. The early symptoms of testicular cancer are not obvious, so it is not easy to detect. Once discovered, it is almost always malignant, so it is crucial to correctly diagnose testicular cancer. So how to correctly diagnose testicular cancer? The following will introduce to you the relevant knowledge on how to correctly diagnose testicular cancer.

There are several ways to correctly diagnose testicular cancer:

First, laboratory examination:

Mainly for serum β-HCG, AFP and LDH detection, these serum tumor markers are of great significance for treatment, follow-up and prognosis. β-HCG is synthesized by syncytiotrophoblast cells, with a serum half-life of 24-36 hours. It is elevated in the blood of patients with choriocarcinoma, embryonal carcinoma and seminoma. Elevated AFP is seen in pure embryonal carcinoma, teratoma, yolk sac tumor and mixed tumors, but pure choriocarcinoma and pure seminoma do not synthesize AFP.

Second, imaging examination:

Scrotal B-ultrasound can help confirm the mass in the testicle and is the preferred method in clinical practice. Abdominal and pelvic CT is used to understand the situation of lymph node metastasis, and chest plain film and CT are used to evaluate the presence of lung metastasis. Therefore, abdominal/pelvic CT is an important basis for staging and grading of all patients. In the follow-up after treatment, positron emission tomography (PET) has high sensitivity and specificity for the evaluation of residual tumors after treatment.

Third, local inspection:

1. The translucency test is negative, and there is no sense of fluctuation. However, a small number of patients in the advanced stage develop effusion or tumor bleeding and form hematoma due to the influence of the tumor on the tunica vaginalis. In the past, some people advocated puncturing and aspirating the effusion of the tunica vaginalis before careful examination. This is no longer adopted, and surgical exploration is advocated to avoid damaging the tumor and causing implantation by piercing the layers of the tunica vaginalis, which affects the treatment effect.

2. Testicular enlargement. Some testicles are completely replaced by tumors. Although they may be smooth, their normal elasticity has disappeared. Generally, there is no obvious tenderness.

3. Testicular tumors are often solid masses. Sometimes, the size of the testicles is similar, but the affected side feels heavier than the healthy side. In addition to checking the scrotum, other parts of the body should also be carefully checked, especially the abdomen for masses, liver enlargement, lower limb edema, and supraclavicular lymph node enlargement.

Patients with testicular tumors should also undergo the following auxiliary examinations: such as chest and bone X-rays, CT examinations, radionuclide scanning, B-ultrasound, pyelography, experimental biochemical immunoassays, and even lymphangiography, in order to observe or speculate the scope and extent of metastasis. Physical examination can touch the enlarged testicle on the affected side, which is tough and heavy, and the translucency test is negative. The concentrations of testicular tumor markers, human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) may be increased in the serum of patients with seminoma, choriocarcinoma, embryonal carcinoma or mixed germ cell tumor, respectively. B-ultrasound shows that the testicles are uniformly enlarged, the echo is enhanced but uneven, and the blood flow signal is strong. CT examination mainly observes the metastasis of retroperitoneal lymph nodes.