抗苗勒管激素和抑制素 B 是评估生育晚期乳腺癌幸存者卵巢功能的激素指标。
Antimullerian hormone and inhibin B are hormone measures of ovarian function in late reproductive-aged breast cancer survivors.
机构信息
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
出版信息
Cancer. 2010 Feb 1;116(3):592-9. doi: 10.1002/cncr.24746.
BACKGROUND
In late reproductive-aged breast cancer survivors, there is a need for real-time biomarkers of postchemotherapy ovarian function. The objective was to determine whether antimullerian hormone (AMH) and inhibin B are such biomarkers. The authors tested whether AMH and inhibin B were impacted by breast cancer treatment by comparing cancer survivors to age-matched control women and determined the association between these hormones and postchemotherapy menstrual pattern.
METHODS
Breast cancer patients (n = 127) with American Joint Committee on Cancer stage I to III disease who were premenopausal at diagnosis were enrolled postchemotherapy and observed. The primary endpoint was chemotherapy-related amenorrhea (CRA) (> or = 12 months of amenorrhea after chemotherapy). Matched pair analyses compared AMH, inhibin B, and follicle-stimulating hormone (FSH) levels between cancer and age-matched control subjects. Associations between hormones, CRA status, and change in CRA status over time were assessed.
RESULTS
The median age of the patients at chemotherapy was 43.2 years (range, 26.7-57.8 years). At enrollment, median follow-up since chemotherapy was 2.1 years, and 55% of subjects had CRA. Compared with age-matched controls, cancer subjects had significantly lower AMH (P = .004) and inhibin B (P < .001) and higher FSH (P < .001). AMH (P = .002) and inhibin B (P = .001) were found to be significantly associated with risk of CRA, even after controlling for FSH. AMH was significantly lower (P = .03) and FSH was significantly higher (P = .04) in menstruating subjects who developed subsequent CRA.
CONCLUSIONS
AMH and inhibin B are 2 additional measures of postchemotherapy ovarian function in late reproductive-aged breast cancer survivors. With further research and validation, these hormones may supplement limited current tools for assessing and predicting postchemotherapy ovarian function.
背景
在晚期生育期乳腺癌幸存者中，需要实时的化疗后卵巢功能生物标志物。目的是确定抗苗勒管激素（AMH）和抑制素 B 是否为这样的生物标志物。作者通过比较癌症幸存者和年龄匹配的对照组女性，测试了 AMH 和抑制素 B 是否受到乳腺癌治疗的影响，并确定了这些激素与化疗后月经模式之间的关联。
方法
招募了诊断时处于绝经前、患有美国癌症联合委员会分期 I 至 III 期疾病的 127 例乳腺癌患者，并在化疗后进行观察。主要终点是化疗相关闭经（CRA）（化疗后闭经> 12 个月）。配对分析比较了癌症患者和年龄匹配的对照组之间 AMH、抑制素 B 和卵泡刺激素（FSH）水平。评估了激素、CRA 状态和 CRA 状态随时间变化的相关性。
结果
患者化疗时的中位年龄为 43.2 岁（范围 26.7-57.8 岁）。在入组时，化疗后中位随访时间为 2.1 年，55%的患者发生 CRA。与年龄匹配的对照组相比，癌症患者的 AMH（P=0.004）和抑制素 B（P<0.001）明显较低，而 FSH（P<0.001）明显较高。即使在控制了 FSH 后，AMH（P=0.002）和抑制素 B（P=0.001）也与 CRA 的风险显著相关。在随后发生 CRA 的月经患者中，AMH 明显较低（P=0.03），FSH 明显较高（P=0.04）。
结论
AMH 和抑制素 B 是晚期生育期乳腺癌幸存者化疗后卵巢功能的另外 2 个指标。随着进一步的研究和验证，这些激素可能会补充目前评估和预测化疗后卵巢功能的有限工具。
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