Tsatsoulis A, Shalet S M, Morris I D, de Kretser D M
Department of Endocrinology, Christie Hospital, Manchester, UK.
Horm Res. 1990;34(5-6):254-9. doi: 10.1159/000181836.
Sertoli and Leydig cell functions were evaluated in men with testicular damage due either to cytotoxic chemotherapy (CCT) or radiotherapy (XRT). Serum immunoactive inhibin, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone concentrations were measured in 15 men (19-50 years) who had received 6-10 courses of combination CCT (mustine, vinblastine, procarbazine and prednisolone) for Hodgkin's disease 1-8 years earlier and 18 men (21-49 years) who had undergone unilateral orchidectomy for testicular seminoma followed by XRT (30 Gy) to the remaining testis, 1-4 years earlier. Normal men (n = 16, 19-36 years) acted as controls. Median inhibin (422 U/l) and testosterone (16.0 nmol/l) levels in the CCT-treated group were not significantly different from controls, whereas median FSH (14.5 IU/l) and LH (10.0 IU/l) levels were higher (p less than 0.0001 and p less than 0.001) than normal (2.9 and 5.5 IU/l). The median inhibin/FSH (I/FSH) ratio in the patients was lower (p less than 0.0001) than in the controls (33.8 vs. 187.0) as was the testosterone/LH (T/LH) ratio (1.7 vs. 3.8, p less than 0.001). In the XRT-treated group, both median inhibin (194.5 U/l) and testosterone (12.7 nmol/l) levels were lower (p less than 0.0001 and p less than 0.01) than normal (532.8 U/l and 20.0 nmol/l) in the presence of greatly elevated FSH (26.0 IU/l) and LH (14.5 IU/l) levels. In conclusion, CCT-induced testicular damage is associated with subtle Sertoli and Leydig cell dysfunction demonstrated by the reduced I/FSH and T/LH ratios; however, compensatory mechanisms maintain normal testosterone and inhibin levels.(ABSTRACT TRUNCATED AT 250 WORDS)
对因细胞毒性化疗（CCT）或放疗（XRT）导致睾丸损伤的男性患者的支持细胞和间质细胞功能进行了评估。检测了15名男性（年龄19 - 50岁）的血清免疫活性抑制素、促卵泡激素（FSH）、促黄体生成素（LH）和睾酮浓度，这些男性在1 - 8年前因霍奇金病接受了6 - 10个疗程的联合CCT（氮芥、长春碱、丙卡巴肼和泼尼松龙）治疗；还检测了18名男性（年龄21 - 49岁）的上述指标，这些男性1 - 4年前因睾丸精原细胞瘤接受了单侧睾丸切除术，随后对剩余睾丸进行了XRT（30 Gy）治疗。正常男性（n = 16，年龄19 - 36岁）作为对照。CCT治疗组的抑制素中位数（422 U/l）和睾酮中位数（16. nM/l）与对照组无显著差异，而FSH中位数（14.5 IU/l）和LH中位数（10.0 IU/l）高于正常水平（2.9和5.5 IU/l）（p < 0.0001和p < 0.001）。患者的抑制素/FSH（I/FSH）中位数比值低于对照组（p < 0.0001）（33.8对187.0），睾酮/LH（T/LH）比值也较低（1.7对3.8，p < < 0.001）。在XRT治疗组中，抑制素中位数（194.5 U/l）和睾酮中位数（12.7 nmol/l）均低于正常水平（532.8 U/l和20.0 nmol/l）（p < 0.0001和p < 0.01），同时FSH（26.0 IU/l）和LH（14.5 IU/l）水平大幅升高。总之，CCT诱导的睾丸损伤与支持细胞和间质细胞的细微功能障碍有关，表现为I/FSH和T/LH比值降低；然而，代偿机制维持了正常的睾酮和抑制素水平。（摘要截短至250字）
