摘要
背景与目的:年轻乳腺癌患者应用促黄体生成素释放激素类似物戈舍瑞林治疗没有个体化用药方案,并缺乏临床可用的指导依据。该研究皆在探讨抗米勒管激素(anti-Müllerian hormone,AMH)在年轻乳腺癌患者卵巢功能抑制个体化治疗的评价作用。方法:选取2012年5月—2014年1月在上海交通大学附属仁济医院因雌激素受体(estrogen receptor,ER)和孕激素受体(progesterone receptor,PR)阳性的乳腺癌41例患者,术前随机分为戈舍瑞林6个疗程+化疗组(简称戈舍瑞林组)20例,化疗组21例,30例同年龄组健康妇女为正常对照组,随访(17.4±6.2)个月。观察两组治疗后的停经时间与复潮时间,于术前1个月、戈舍瑞林组或化疗组术后月经复潮后3、6个月检测AMH、促卵泡激素(follicle-stimulating hormone,FSH)和E_2水平。正常对照组在相应时间段内检测AMH、FSH和E_2水平。结果:3组患者的术前临床资料及术前FSH、E_2水平差异均无统计学意义(P>0.05),乳腺癌患者术前AMH水平较正常对照组降低,差异有统计学意义(P=0.04);戈舍瑞林组较化疗组停经时间更短,差异有统计学意义(P=0.00);戈舍瑞林组较化疗组复潮时间更短,差异有统计学意义(P=0.00);与正常对照组及术前比较,戈舍瑞林组及化疗组FSH、E_2水平在5个测定时间的差异均无统计学意义(P>0.05);戈舍瑞林组及化疗组在5个测定时间的AMH水平均显著降低,差异均有统计学意义(P=0.00),两组在复潮后3、6个月AMH水平逐渐上升,差异均有统计学意义(P<0.05);与化疗组相比,戈舍瑞林组的AMH水平下降明显,戈舍瑞林组的AMH水平在复潮6个月后比化疗组升高,差异均有统计学意义(P<0.05)。结论:年轻乳腺患者在卵巢功能抑制治疗+化疗过程中,AMH较其他评价卵巢储备的指标明显下降,在其他指标恢复术前水平后仍提示卵巢受损,提示AMH可以作为评价年轻乳腺癌患者卵巢功能的指标,亦有可能成为戈
Background and purpose： The young breast cancer patients were treated with goserelin without individualized regimen, and lack of available clinical marker. The aim of this study was to investigate the role of anti- Mullerian hormone （AMH） in evaluation of individualized treatment of ovarian fimction suppression in the young breast cancer patients. Methods： Forty-one young patients with estrogen receptor （ER） and progesterone receptor （PR） positive breast cancer from May 2012 to Jan. 2014 were randomly divided into 2 groups to undergo radical resection of breast cancer. According to postoperative treatment, one group was treated with goserelin ＋ chemotherapy （n=20）, and the other group received chemotherapy alone （n=21）. Thirty female patients in the same age group were selected as normal control group. The time of menopause and menstrual recovery after the goserelin ＋ chemotherapy or chemotherapy alone were observed in 2 groups. In early follicular phase （day 3-5） of the cycle preceding the operation and 3, 6 courses after the goserelin ＋ chemotherapy treatment or chemotherapy treatment, serum levels of AMH, FSH and E2 were measured in 2 groups. Accordingly, serum levels ofAMH, FSH and E2 were evaluated as well in normal control group. Results： There were no significant differences in preoperative general conditions and preoperative serum FSH and E2 levels among the 3 groups （P〉0.05）. Compared with normal control group, the preoperative serum AMH levels of young breast cancer patients were decreased significantly （P=0.04）. The menopause time and menstrual recovery time in 2 chemotherapy groups were significantly shorter than that in normal control group （P=0.00）. Compared with normal control group and preoperative measurement, the differences in serum FSH and E2 levels were not statistically significant in goserelin ＋ chemotherapy group or chemotherapy alone group （P〈0.05）. The serum AMH levels measured at different time points of the goserelin ＋ chemoth
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2015年第12期983-988,共6页
China Oncology
基金
上海市浦东新区青年医学人才项目(PWRq2012-31)
上海市卫计委课题(201440468)
关键词
抗米勒管激素
戈舍瑞林
年轻乳腺癌患者
卵巢功能抑制
Anti-Mullerian hormone
Goserelin
Young breast cancer patients
Ovarian function suppression
