How to diagnose testicular cancer more accurately

Testicular cancer is a very serious cancer that occurs in the testicular tissue of men and seriously threatens the patient's fertility. The early symptoms of testicular cancer are not obvious, so patients often fail to be diagnosed in time, which causes patients to miss the good opportunity for treatment. Therefore, early diagnosis is the key. So how to diagnose testicular cancer more accurately? Today I will share with you the method of diagnosing testicular cancer.

Testicular cancer can be diagnosed through laboratory diagnosis, pathological diagnosis and imaging diagnosis:

① Laboratory diagnosis:

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 spermatogonia. Elevated AFP is seen in pure embryonal carcinoma, teratocarcinoma, yolk sac tumor and mixed tumors, but pure choriocarcinoma and pure spermatogonia do not synthesize AFP. The serum half-life of AFP is 5-7 days. Elevated LDH can be seen in testicular tumors, but its sensitivity and specificity are not high. The degree of increase can be used to indicate the severity or extensiveness of the lesion, and the increase after treatment can also indicate recurrence. The time required for LDH to return to normal can predict the patient's prognosis, especially for medium-risk patients. The longer it takes to return to normal, the worse the prognosis.

②Pathological diagnosis:

Although a puncture biopsy of a testicular tumor can confirm the diagnosis, there is a risk of tumor implantation and metastasis, so transscrotal testicular puncture biopsy should be prohibited. Differential diagnosis The differential diagnosis of testicular cancer includes epidermoid or dermoid cysts in the testicle, testicular torsion, epididymitis, epididymo-orchitis, and hydrocele.

③Imaging diagnosis

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.