Andrology Unit of the Department of Urology, Erasmus MC, 3000 CA Rotterdam, The Netherlands.
Hum Reprod. 2010 Aug;25(8):1877-83. doi: 10.1093/humrep/deq104. Epub 2010 Jun 14.
We assessed sperm DNA fragmentation index (DFI) in cancer patients before and after treatment to evaluate if sperm DNA integrity is compromised by cancer itself or its treatment.
In a prospective study, DFI was assessed in 127 patients diagnosed with testicular germ cell tumours (TGCT), Hodgkin's lymphoma (HL), non-Hodgkin's lymphoma (NHL) and various malignancies. The severity of cancer and tumour markers at diagnosis was recorded. Follow-up DFI after treatment was available in 52 patients who were mostly less severely affected.
In patients diagnosed with TGCT, HL and various malignancies, pretreatment DFI levels were not significantly different from that of proven fertile controls, but in patients with NHL an increased DFI was found. An overall significant decrease in post-treatment DFI (13.2% range 5.0-70.5) compared with pretreatment values (17.1% range 5.1-66.6) was found (P = 0.040). In TGCT patients, post-treatment DFI was significantly higher in patients who were treated with radiotherapy (16.9% range 11.5-39.9) compared with that in patients treated with chemotherapy (CT) alone (10.9% range 5.5-39.9) (P = 0.037). In HL patients, the type of treatment or number of CT cycles was not associated with DFI. Overall, post-treatment DFI in cancer patients was not significantly different from that of proven fertile controls.
In this study, the presence of cancer does not seem to negatively affect the sperm DNA integrity in TGCT and HL patients; only NHL patients showed increased DFI at the time of diagnosis compared with healthy controls. Our results confirm previous reports that DFI decreases significantly following various anti-cancer treatments. In contrast, radiotherapy in TGCT patients is associated with an increase in DFI compared with CT treatment alone.
我们评估了癌症患者治疗前后的精子 DNA 碎片化指数（DFI），以评估精子 DNA 的完整性是否因癌症本身或其治疗而受损。
在一项前瞻性研究中，我们评估了 127 例诊断为睾丸生殖细胞肿瘤（TGCT）、霍奇金淋巴瘤（HL）、非霍奇金淋巴瘤（NHL）和各种恶性肿瘤患者的 DFI。记录了诊断时癌症的严重程度和肿瘤标志物。52 例治疗后随访 DFI 的患者病情大多较轻。
在诊断为 TGCT、HL 和各种恶性肿瘤的患者中，预处理 DFI 水平与已证实的生育力对照组无显著差异，但在 NHL 患者中发现 DFI 升高。与预处理值（17.1%范围 5.1-66.6）相比，治疗后 DFI 总体显著下降（13.2%范围 5.0-70.5）（P = 0.040）。在 TGCT 患者中，接受放疗（16.9%范围 11.5-39.9）的患者治疗后 DFI 明显高于仅接受化疗（CT）的患者（10.9%范围 5.5-39.9）（P = 0.037）。在 HL 患者中，治疗类型或 CT 周期数与 DFI 无关。总体而言，癌症患者治疗后的 DFI 与已证实的生育力对照组无显著差异。
在这项研究中，癌症的存在似乎不会对 TGCT 和 HL 患者的精子 DNA 完整性产生负面影响；只有 NHL 患者在诊断时与健康对照组相比，DFI 升高。我们的结果证实了先前的报告，即各种抗癌治疗后 DFI 显著下降。相比之下，TGCT 患者的放疗与单独 CT 治疗相比，DFI 增加。
