Study On The Difference Of Left RenalTesticular Vein Diameter Ratio Between Patients With Left Testicular Malignancy And Normal Population

Objective:To study the difference of left testicular/renal vein diameter between normal people and patients with left testicular cancer,and further explore the relationship between nutcracker phenomenon,left testis/renal vein diameter and risk factors,clinicopathological staging and tumor markers of left testicular cancer,provide more evidence for clinical diagnosis and treatment.Methods:From May 2015 to December 2019,31 patients with left testicular cancer who were treated in Tumor Hospital Affiliated to Guangxi Medical University for orchiectomy and proved to be testicular cancer by postoperative pathology,and 31 normal men who were treated in the Second Affiliated Hospital of Guangxi Medical University and Tumor Hospital Affiliated to Guangxi Medical University for physical examination,were selected as the study objects.According to whether it is left testicular cancer,it is divided into two groups:tumor group and normal group,the Fisher test was used to analyze the difference in the diagnosis rate of the nutcracker phenomenon between normal people and patients with left testicular cancer,the independent sample t test was used to analyze the differences of renal vein diameter ratio（LRV ratio）,testicular vein average diameter(TV_avg),testicular/renal vein average diameter ratio(TV_avg/RV_avg),and minimum testicular/renal vein ratio(TV_min/RV_min)between the two groups,the Logistic regression were used to analyze the risk factors of left testicular cancer,and the Pearson rank correlation analysis was used to analyze the relationship between renal vein ratio,average testicular vein diameter,pathological stage,tumor size and tumor markers.Results:The x²value of the diagnosis rate of nutcracker phenomenon between the tumor group and the normal group P=0.034,and the difference was statistically significant.Compared with the normal group,the BMI of the tumor group was smaller（P<0.001）,and the ratio of LRV,TV_avg,TV_avg/RV_avg,TV_min/RV_minand LDH were larger（P<0.001,0.01,0.019,0.03 and 0.037,respectively）.Through Logistic multivariate regression analysis,it was concluded that the P values of BMI and LRV were all less than 0.05,which were the influencing factors for the development of left testicular cancer.The ratio of LRV was positively correlated with pathological stage,tumor size,lymph nodes,distant metastasis,AFP and LDH（r values were 0.612,0.684,0.586,0.38,0.37,0.373,and P values were<0.001,<0.001,0.001,0.035,0.04,and 0.03,respectively）.The average diameter of left testicular vein was positively correlated with pathological stage,tumor size,distant metastasis and LDH（r values were 0.385,0.384,0.581 and 0.401,and P values were 0.033,0.033,0.001 and 0.025,respectively）.Conclusion:1.Both LRV ratio and BMI were associated with the occurrence of left testicular malignancy;2.Compared with the general population,patients in the tumor group had a higher incidence of nutcracker phenomenon and a larger mean diameter of the left testicular vein;3.LRV ratio was positively correlated with pathological stage and tumor markers.