BackgroundTesticular microlithiasis is the presence of small calcifications in the testicular parenchyma. The association between testicular microlithiasis and germ cell neoplasia in situ, a precursor to testicular cancer, is still unclear.ObjectivesTo determine the incidence of germ cell neoplasia in situ in men with testicular microlithiasis and evaluate the indication for testicular biopsy according to risk factors in the form of male infertility/reduced semen quality, testicular atrophy, and history of cryptorchidism.Materials and methodsThis retrospective case series included all patients diagnosed with testicular microlithiasis who underwent testicular biopsies at three hospitals in Denmark between 2007 and 2021. The medical records of 167 patients were reviewed, and data on patient demographics, testicular microlithiasis characteristics, risk factors, histological findings, and treatments were collected. The main outcome measure was the incidence of germ cell neoplasia in situ in relation to each risk factor. The data were analyzed using descriptive statistics. Logistic regression was used to examine the odds ratio of germ cell neoplasia in situ in patients with testicular microlithiasis and testicular atrophy.ResultsGerm cell neoplasia in situ was found in 13 out of 167 patients (7.8% [95% confidence interval: 4.3, 13.2]). Eleven of these had testicular atrophy resulting in a significantly higher incidence in this group than other risk factors (odds ratio 9.36 [95% confidence interval: 2.41, 61.88]; p = 0.004).DiscussionThe study comprises the largest cohort to date of men who have undergone testicular biopsies because of testicular microlithiasis and additional risk factors. Limitations include its retrospective design, and relatively low absolute numbers of patients with germ cell neoplasia in situ on biopsies.ConclusionThis study found that men with testicular microlithiasis and testicular atrophy are at an increased risk of germ cell neoplasia in situ. Additionally, our results indicate that biopsies should be considered in men with a combination of subfertility and bilateral testicular microlithiasis. Our findings do not support testicular biopsies for men with testicular microlithiasis and other risk factors.

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患有睾丸微石症和其他癌症危险因素的男性睾丸活检：病例系列

背景睾丸微石症是睾丸实质中存在小钙化。睾丸微石症与睾丸癌前兆的生殖细胞原位肿瘤之间的关系尚不清楚。 目的 确定患有睾丸微石症的男性中生殖细胞原位肿瘤的发生率，并根据男性睾丸微石症的危险因素评估睾丸活检的指征。男性不育/精液质量下降、睾丸萎缩和隐睾病史。材料和方法本回顾性病例系列包括 2007 年至 2021 年间在丹麦三家医院接受睾丸活检的所有诊断为睾丸微石症的患者。167 名患者的医疗记录进行了审查，并收集了有关患者人口统计学、睾丸微石症特征、危险因素、组织学结果和治疗的数据。主要结果指标是与每个危险因素相关的原位生殖细胞肿瘤的发生率。使用描述性统计分析数据。采用Logistic回归分析睾丸微石症和睾丸萎缩患者中生殖细胞原位肿瘤的比值比。结果167名患者中有13例发现生殖细胞原位肿瘤（7.8% [95%置信区间: 4.3, 13.2] ）。其中 11 人患有睾丸萎缩，导致该组的发病率显着高于其他危险因素（比值比 9.36 [95% 置信区间：2.41, 61.88]；p= 0.004）。讨论该研究包括迄今为止最大的因睾丸微石症和其他危险因素而接受睾丸活检的男性队列。局限性包括其回顾性设计，以及活检中生殖细胞原位肿瘤患者的绝对数量相对较低。结论这项研究发现，患有睾丸微石症和睾丸萎缩的男性患生殖细胞原位肿瘤的风险增加。此外，我们的结果表明，对于患有生育力低下和双侧睾丸微石症的男性应考虑进行活检。我们的研究结果不支持对患有睾丸微石症和其他危险因素的男性进行睾丸活检。