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阿那曲唑对绝经后早期乳腺癌女性激素水平的影响。

Effect of anastrozole on hormone levels in postmenopausal women with early breast cancer.

作者信息

Kyvernitakis I, Albert U-S, Kalder M, Winarno A-S, Hars O, Hadji P

机构信息

Department of Gynecology and Obstetrics, Reproductive Medicine and Osteoporosis, Philipps-University of Marburg , Germany.

出版信息

Climacteric. 2015 Feb;18(1):63-8. doi: 10.3109/13697137.2014.929105. Epub 2014 Aug 17.

Abstract

OBJECTIVES

The aim of this study was to investigate the influence of anastrozole on serum hormone levels in postmenopausal women with hormone receptor-positive breast cancer.

METHODS

We prospectively determined serum levels of estradiol, testosterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), follicle stimulating hormone (FSH) and luteinizing hormone (LH) at screening, as well as after 12 and 24 months of treatment and studied the associations with markers of bone turnover and bone mineral density (BMD).

RESULTS

Altogether, a full set of hormone levels was available for 70 patients. Anastrozole treatment led to decreases of 92.1% for estradiol and 11.1% for LH over the observation period (p < 0.001). Conversely, FSH, DHEAS and testosterone concentrations increased by 5.9%, 33.3% and 50%, respectively (p < 0.001). SHBG levels remained stable during the 24 months of treatment (p = 0.355). There were modest associations between FSH, SHBG, CrossLaps and N-terminal propeptide of human procollagen type I (p < 0.05). Moreover, SHBG correlated positively with the BMD of femoral neck, total hip, total hip T-score, lumbar spine and the lumbar spine T-score, whereas FSH and estradiol correlated with the lumbar spine T-score (p < 0.05).

CONCLUSIONS

During the 24 months of follow-up, treatment with anastrozole decreased the serum levels of estradiol and LH. Furthermore, we found notable increases of serum levels of FSH, DHEAS and testosterone in the first 12 months of treatment, stabilizing thereafter. Additionally, we were able to correlate hormone levels with markers of bone turnover and BMD for the first time in this regard.

摘要

目的

本研究旨在探讨阿那曲唑对绝经后激素受体阳性乳腺癌女性血清激素水平的影响。

方法

我们前瞻性地测定了筛查时、治疗12个月和24个月后的雌二醇、睾酮、硫酸脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)、促卵泡激素(FSH)和促黄体生成素(LH)的血清水平,并研究了其与骨转换标志物和骨密度(BMD)的相关性。

结果

共有70例患者获得了完整的激素水平数据。在观察期内,阿那曲唑治疗使雌二醇水平降低了92.1%,LH水平降低了11.1%(p<0.001)。相反,FSH、DHEAS和睾酮浓度分别增加了5.9%、33.3%和50%(p<0.001)。SHBG水平在24个月的治疗期间保持稳定(p=0.355)。FSH、SHBG、交联C端肽和I型前胶原N端前肽之间存在适度相关性(p<0.05)。此外,SHBG与股骨颈、全髋、全髋T值、腰椎和腰椎T值的骨密度呈正相关,而FSH和雌二醇与腰椎T值相关(p<0.05)。

结论

在24个月的随访期间,阿那曲唑治疗降低了血清雌二醇和LH水平。此外,我们发现治疗的前12个月血清FSH、DHEAS和睾酮水平显著升高,此后趋于稳定。此外,在这方面我们首次能够将激素水平与骨转换标志物和骨密度相关联。

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