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Testicular G2 usually refers to the G2 grade (moderately differentiated) in the pathological grading of testicular germ cell tumors, which is a tumor type with moderate malignancy. The pathological grades of testicular tumors mainly include G1 (well differentiated), G2 (moderately differentiated), and G3 (poorly differentiated or undifferentiated). The higher the grade, the greater the atypia of the tumor cells and the higher the degree of malignancy.

1. Pathological grading basis

Testicular G2 grading is based on the morphological characteristics of tumor cells under the microscope, including nuclear size, chromatin distribution, number of mitotic figures and other indicators. Moderately differentiated G2 tumors still retain part of the normal seminiferous tubule structure, but the cells are arranged in a disordered manner and have obvious nuclear atypia. Such tumors may have local infiltration or lymph node metastasis.

2. Common tumor types

G2 grade is more common in non-seminoma, such as embryonal carcinoma, yolk sac tumor, teratoma, etc. Seminomas usually do not use the G grading system. Confirmation requires the detection of immunohistochemical markers, such as PLAP, CD117, AFP, HCG, etc. Treatment options vary for different tumor types.

3.Clinical manifestations

The patient may feel a painless lump in the testicles, accompanied by a feeling of swelling in the scrotum. In some cases, gynecomastia develops due to tumors secreting HCG. In the late stage, low back pain caused by retroperitoneal lymph node enlargement or cough and hemoptysis caused by lung metastasis may occur. B-ultrasound examination showed heterogeneous hypoechoic masses in the testicles.

4. Treatment principles

Standard treatment includes radical orchiectomy with retroperitoneal lymph node dissection. After surgery, adjuvant chemotherapy is selected based on the pathological type and stage. The commonly used regimen is BEP (bleomycin + etoposide + cisplatin). Radiation therapy is suitable for seminoma but has limited effect on non-seminoma. Tumor markers and imaging reexaminations need to be monitored regularly.

5. Prognostic factors

The 5-year survival rate for G2 tumors is about 80%-90%, but the specific prognosis depends on the clinical stage, tumor type and sensitivity to chemotherapy. Patients with lung metastasis, mediastinal lymph node metastasis or persistently elevated tumor markers have a poor prognosis. Long-term follow-up is required after treatment, focusing on the condition of the contralateral testis, retroperitoneum and lungs.

After diagnosis of testicular G2 tumor, staging examinations such as chest CT and abdominal MRI should be completed as directed by the doctor. During treatment, pay attention to keeping the perineum clean and dry, and avoid scrotal trauma caused by strenuous exercise. The diet is recommended to be high-protein, high-vitamin and easily digestible foods. During chemotherapy, ginger juice and lemon water can be consumed to relieve nausea. Tumor markers and imaging should be reviewed every 3 months within 1 year after surgery, and regular follow-up is recommended within 5 years. If symptoms such as sudden weight loss, bone pain, or hemoptysis occur, seek medical attention immediately.