Wiechno Paweł, Demkow Tomasz, Kubiak Krzysztof, Sadowska Małgorzata, Kamińska Janina
Department of Urology, Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland.
Eur Urol. 2007 Nov;52(5):1448-54. doi: 10.1016/j.eururo.2007.05.012. Epub 2007 May 25.
To assess the degree of hormonal abnormalities in testicular cancer survivors and the effect of these changes on patients' quality of life.
Men with complete remission of testicular cancer for over 2 yr were eligible. Patients completed the State-Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), the International Index of Erectile Function (IIEF), and the Sexual Functioning Questionnaire (SFQ), and rated their physical and psychological well-being, quality of life, and relationship with their partner. Levels of the hormones testosterone, estradiol, thyreotropin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin were determined. Relationships between hormone levels and questionnaire results were assessed.
A total of 326 men were tested, of whom 269 were treated with platinum-based chemotherapy. The most common endocrine abnormalities were above-normal gonadotropin levels (LH, 55%, and FSH, 49% of cases) and lowered testosterone (15%). Twenty-seven percent (STAI) and 28% (HADS) of the patients had abnormal anxiety levels, while the depression rate was 15% (BDI) and 18% (HADS); 40% of patients had erectile dysfunction. Linear regression analysis excluding the influence of age showed higher depression levels in the BDI among patients with elevated LH (p=0.010) or FSH (p=0.017). Patients with above-normal LH showed increased sexual problems in the SFQ (p=0.030). Elevated gonadotropins correlated with deteriorated physical well-being (p=0.028). Men with abnormal estradiol were more prone to erectile dysfunction (p=0.009).
Hormonal abnormalities have a negative impact on the quality of life of testicular cancer survivors.
评估睾丸癌幸存者激素异常的程度以及这些变化对患者生活质量的影响。
睾丸癌完全缓解超过2年的男性符合条件。患者完成状态-特质焦虑量表（STAI）、医院焦虑抑郁量表（HADS）、贝克抑郁量表（BDI）、国际勃起功能指数（IIEF）和性功能问卷（SFQ），并对他们的身心健康、生活质量以及与伴侣的关系进行评分。测定睾酮、雌二醇、促甲状腺激素、促卵泡激素（FSH）、促黄体生成素（LH）和催乳素的激素水平。评估激素水平与问卷结果之间的关系。
共对326名男性进行了检测，其中269名接受了铂类化疗。最常见的内分泌异常是促性腺激素水平高于正常（LH为55%的病例，FSH为49%的病例）以及睾酮降低（15%）。27%（STAI）和28%（HADS）的患者焦虑水平异常，而抑郁率为15%（BDI）和18%（HADS）；40%的患者存在勃起功能障碍。排除年龄影响的线性回归分析显示，LH（p=0.010）或FSH（p=0.017）升高的患者在BDI中的抑郁水平更高。LH高于正常的患者在SFQ中显示出性问题增加（p=0.030）。促性腺激素升高与身体健康恶化相关（p=0.028）。雌二醇异常的男性更容易出现勃起功能障碍（p=0.009）。
激素异常对睾丸癌幸存者的生活质量有负面影响。
