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睾丸肿瘤患者在接受顺铂、依托泊苷和博来霉素化疗后,精子中非整倍体增加。

Increased aneuploidy in spermatozoa from testicular tumour patients after chemotherapy with cisplatin, etoposide and bleomycin.

作者信息

De Mas P, Daudin M, Vincent M C, Bourrouillou G, Calvas P, Mieusset R, Bujan L

机构信息

Human Fertility Research Group and CECOS Midi-Pyrénées, Centre de Stérilité Masculine, Service d'Uro-Andrologie, Hôpital La Grave and Service de Génétique Médicale, Hôpital Purpan, Toulouse, France.

出版信息

Hum Reprod. 2001 Jun;16(6):1204-8. doi: 10.1093/humrep/16.6.1204.

Abstract

Testicular cancer is the most common neoplasia occurring in the young male population. The PEB (cisplatin, etoposide and bleomycin) adjuvant chemotherapy usually proposed after orchidectomy in non seminomatous tumours, and in metastatic seminomas, has improved the long-term survival of these patients. Following an azoospermic period, sperm cell recovery is generally observed after treatment delivery, but little is known about the genetic consequences on these new spermatozoa. To estimate the chromosomal consequences of this chemotherapy on sperm cells during the period of recovery of spermatogenesis, sperm cell aneuploidy was studied in testicular cancer patients, at 6-18 months after PEB adjuvant chemotherapy delivery, using fluorescence in-situ hybridization (FISH) of chromosomes 7, 16, 18, X and Y with specific DNA probes. A significant increase in the frequency of diploidy and disomy for chromosomes 16, 18 and XY was observed in treated patients compared with a healthy control group. Spermatozoa aneuploidy occurring during the spermatogenesis recovery period might be a possible side effect of the PEB regimen. Thus, practitioners should be advised to provide counselling about the need for an appropriate duration of contraception. Moreover, genetic counselling should be offered in cases of pregnancy occurring soon after the end of chemotherapy.

摘要

睾丸癌是年轻男性群体中最常见的肿瘤。对于非精原细胞瘤以及转移性精原细胞瘤,通常在睾丸切除术后建议采用PEB(顺铂、依托泊苷和博来霉素)辅助化疗,这提高了这些患者的长期生存率。在经历无精子症期后,治疗后通常会观察到精子细胞恢复,但对于这些新生精子的遗传后果却知之甚少。为了评估在精子发生恢复期间这种化疗对精子细胞的染色体影响,在接受PEB辅助化疗6 - 18个月后的睾丸癌患者中,使用针对7号、16号、18号染色体以及X和Y染色体的特异性DNA探针进行荧光原位杂交(FISH),研究精子细胞非整倍体情况。与健康对照组相比,在接受治疗的患者中观察到16号、18号染色体以及XY染色体的二倍体和双体频率显著增加。精子发生恢复期出现的精子非整倍体可能是PEB方案的一种潜在副作用。因此,应建议从业者为患者提供关于适当避孕时长必要性的咨询。此外,对于化疗结束后不久怀孕的情况,应提供遗传咨询。

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