Value of high-frequency ultrasound combined with alpha-fetoprotein in accurate qualitative diagnosis of pediatric testicular tumors
10.3760/cma.j.cn431274-20210512-00534
- VernacularTitle:高频超声结合甲胎蛋白对小儿睾丸肿瘤精确定性诊断的价值
- Author:
Yunxiang PAN
1
;
Huimin WANG
;
Siwei AN
;
Yaojia LIANG
;
Rui DU
;
Ning SHANG
;
Limin WANG
;
Xiaoyan MA
Author Information
1. 广东省妇幼保健院超声诊断科，广州 511400
- Keywords:
Testicular neoplasms;
Yolk sac tumor;
Ultrasonography;
Alpha-fetoprotein;
Child
- From:
Journal of Chinese Physician
2021;23(6):817-821
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of high frequency ultrasound combined with serum alpha-fetoprotein (AFP) in the accurate qualitative diagnosis of pediatric testicular tumors.Methods:The ultrasound characteristics (physical properties, calcification, alder blood flow classification) and AFP levels of 47 testicular tumors confirmed by operation and pathology were analyzed retrospectively. The tumors were further divided into two ways: malignant tumor group and benign tumor group, yolk sac tumor group and non yolk sac tumor group. The characteristics of ultrasound and the accurate qualitative diagnosis efficiency of AFP in testicular tumors were analyzed by receiver operating characteristic curve (ROC).Results:18 cases of yolk sac tumor showed solid or almost solid mass, which may be accompanied by several small anechoic areas without calcification. The Alder blood flow grade were grade 3. 29 cases of nonyolk sac tumor showed cystic, solid or mixed mass, most of them have calcification and some of them showed honeycomb echo. Alder blood flow grade were 0-3 grade. ROC curve analysis showed that the area under the curve, sensitivity and specificity of the ultrasound characteristics and AFP in the diagnosis of pediatric testicular malignancies were: solid or almost solid mass (0.894, 83.3%, 95.5%), and no calcification (0.904, 94.4%, 86.4%), Alder blood flow level 3 (0.941, 88.9%, 95.5%), AFP by best cut-off value 18.8 ng/ml (0.972, 100%, 95.5%), ultrasound features combined with AFP (0.992, 100%, 90.9%). All the testicular malignancies, such as yolk sac tumor, immature teratoma, teratoma combined with yolk sac tumor, can be identified by ultrasound features combined with AFP. Further analysis showed that the sensitivity and specificity of the diagnosis of yolk sac tumor with combined solid or almost solid and no calcification were both 100.0%, which can accurately distinguish all cases of yolk sac tumor.Conclusions:Pediatric testicular yolk sac tumor has specific ultrasound performance, high-frequency ultrasound can make a relatively accurate diagnosis, combined with serum AFP can further make a relatively accurate qualitative diagnosis of other malignant tumors of the testis in children.
