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Testicular parenchymal abnormalities in Klinefelter syndrome： a question of cancer？ Examination of 40 consecutive patients

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Asian Journal of Andrology 2015年第1期17卷 154-158,I0012页

作者： Giacomo Accardo Gianfranco Vallone Daniela Esposito filomena barbato Andrea Renzullo Giovanni Conzo Giovanni Docimo Katherine Esposito Daniela Pasquali Department of Cardiothoracic and Respiratory Sciences Endocrine Unit Department of Biomorphological and Functional Sciences Second University of Naples Naples Italy Department of Clinical and Experimental Medicine Second University of Naples Naples Italy.

Klinefelter syndrome （KS） is a hypergonadotropic hypogonadism characterized by a 47, XXY karyotype. The risk of testicular cancer in KS is of interest in relation to theories about testicular cancer etiology generally; nevertheless it seems to be low. We evaluated the need for imaging and serum tumor markers for testicular cancer screening in KS. Participants were 40 consecutive KSpatients, enrolled from December 2009 to January 2013. Lactate dehydrogenase （LDH）, alpha-fetoprotein （AFP）, and beta-human chorionic gonadotrophin subunit （^-HCG） serum levels assays and testicular ultrasound （US） with color Doppler, were carried out at study entry, after 6 months and every year for 3 years. Abdominal magnetic resonance （MR） was performed in KS when testicular US showed micro-calcifications, testicular nodules and cysts. Nearly 62% of the KS had regular testicular echotexture, 37.5% showed an irregular echotexture and 17.5% had micro-calcifications and cysts. Eighty seven percent of KS had a regular vascular pattern, 12.5% varicocele, 12.5% nodules 〈1 cm, but none had nodules 〉1 cm. MR ruled out the diagnosis of cancer in all KS with testicular micro calcifications, nodules and cysts. No significant variations in LDH, AFP, and ^-HCG levels and in US pattern have been detected during follow-up. We compared serum tumor markers and US pattern between KS with and without cryptorchidism and no statistical differences were found. We did not find testicular cancer in KS, and testicular US, tumor markers and MR were, in selected cases, useful tools for correctly discriminating benign from malignant lesions.

关键词： abdomen magnetic resonance alpha-fetoprotein beta-human chorionic gonadotrohin subunit klinefelter syndrome lactate dehydrogenase testicular ultrasound

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