Thomas Claire, Cans Christine, Pelletier Roberte, De Robertis Christine, Hazzouri Mira, Sele Bernard, Rousseaux Sophie, Hennebicq Sylviane
Centre d'étude et de Conservation des Oeufs et du Sperme humain, Service de génétique, CHU Grenoble, Grenoble 9, France.
Clin Cancer Res. 2004 Oct 1;10(19):6535-43. doi: 10.1158/1078-0432.CCR-04-0582.
Lymphomas and testicular cancers are the most frequent malignancies among young men. With recent improvement of survival rates, for many patients, the question is raised of the consequences of the anticancer treatments on their fertility and more specifically of a potential genetic risk for the offspring. This article presents the study of sperm aneuploidy rates in the largest population of cancer-treated patients studied thus far.
In the present study, 38 patients were initially included 7 months to 5 years after a cancer treatment by chemotherapy and/or radiotherapy for testicular cancer (n = 19) or lymphoma (n = 19). Twelve of them were azoospermic. Sperm aneuploidy rates of chromosomes X, Y, 13, 18, and 21 were analyzed by multicolor fluorescent in situ hybridization in the 26 other patients.
In most cases, the disomy/diploidy rates after cancer therapy did not significantly differ from those observed in the group of control healthy donors. Only five patients (one lymphoma and four testicular cancer) showed significant but still moderate increases in disomic and/or diploid sperm. For the lymphoma patient, the short posttherapeutic delay after the treatment could explain the elevated aneuploidy rates, whereas no risk factor in the clinical, biological, or therapeutic records could be identified in any of the four testicular cancer patients with elevated sperm aneuploidy rates.
These data suggest an absence of long-term effect of anticancer therapy on sperm aneuploidy rates, and therefore, no long-term increased risk of aneuploidy for the offspring obtained either spontaneously or after assisted reproductive techniques.
淋巴瘤和睾丸癌是年轻男性中最常见的恶性肿瘤。随着近期生存率的提高,对于许多患者而言,抗癌治疗对其生育能力的影响,尤其是对后代潜在的遗传风险问题随之而来。本文介绍了迄今为止在接受癌症治疗的最大患者群体中对精子非整倍体率的研究。
在本研究中,38例患者在接受化疗和/或放疗治疗睾丸癌(n = 19)或淋巴瘤(n = 19)后7个月至5年被纳入研究。其中12例无精子症。通过多色荧光原位杂交技术分析了其他26例患者的X、Y、13、18和21号染色体的精子非整倍体率。
在大多数情况下,癌症治疗后的二体/二倍体率与健康对照供体组观察到的率无显著差异。只有5例患者(1例淋巴瘤和4例睾丸癌)的二体和/或二倍体精子有显著但仍适度的增加。对于淋巴瘤患者,治疗后较短的治疗间隔时间可以解释非整倍体率升高的原因,而在精子非整倍体率升高的4例睾丸癌患者中,在临床、生物学或治疗记录中均未发现危险因素。
这些数据表明抗癌治疗对精子非整倍体率没有长期影响,因此,无论是自然受孕还是辅助生殖技术后受孕,后代非整倍体的长期风险均未增加。