青年起病的结直肠癌患者的生育力：一项关于林奇综合征患者的研究。
Fertility after young-onset colorectal cancer: a study of subjects with Lynch syndrome.
作者信息
Stupart D, Win A K, Winship I M, Jenkins M
机构信息
Department of Surgery, Deakin University, Geelong, Victoria, Australia.
Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
出版信息
Colorectal Dis. 2015 Sep;17(9):787-93. doi: 10.1111/codi.12940.
AIM
Infertility is a concern for young survivors of colorectal cancer (CRC), but this risk is not well quantified. Carriers of mismatch repair (MMR) mutations are a useful cohort for studying fertility after CRC as they commonly develop CRC when young, and unaffected family members provide demographically similar controls. The aim of this study was to determine the effect of CRC on fertility in a large cohort of MMR mutation carriers.
METHOD
Mismatch repair mutation carriers identified from the Australasian Colorectal Cancer Family Registry were included. For each year of life within the fertile age range (15-49), the number of living individuals and the number of children born to them were determined. Individuals were grouped by whether or not they had had a diagnosis of CRC by that age. Age-specific and total fertility rates were calculated.
RESULTS
We identified 1068 subjects (611 women and 457 men), of whom 467 were diagnosed with CRC. There were 1192 births during 18 674 person-years of follow-up to the women and 814 births during 14 013 person-years of follow-up to the men. The total fertility rate was decreased in women after a diagnosis of CRC compared with those who did not have CRC (1.3 vs 2.2; P = 0.0011), but age-specific fertility was only reduced in the 20-24-year age group. In men the total fertility rate was similar for both groups (2.0 vs 1.8; P = 0.27).
CONCLUSION
Age-specific fertility was decreased in female CRC survivors with Lynch syndrome aged 20-24, but not in older women or in men.
目的
不孕是结直肠癌（CRC）年轻幸存者关注的问题，但这种风险尚未得到充分量化。错配修复（MMR）突变携带者是研究CRC后生育能力的有用队列，因为他们通常在年轻时患CRC，未受影响的家庭成员可提供人口统计学上相似的对照。本研究的目的是确定CRC对大量MMR突变携带者生育能力的影响。
方法
纳入从澳大利亚结直肠癌家族登记处确定的错配修复突变携带者。对于育龄期（15 - 49岁）内的每一年，确定存活个体数量及其生育的子女数量。个体按该年龄是否被诊断患有CRC进行分组。计算年龄别生育率和总生育率。
结果
我们确定了1068名受试者（611名女性和457名男性），其中467人被诊断患有CRC。女性在18674人年的随访期间有1192例分娩，男性在14013人年的随访期间有814例分娩。与未患CRC的女性相比，诊断患有CRC的女性总生育率降低（1.3对2.2；P = 0.0011），但年龄别生育率仅在20 - 24岁年龄组降低。男性两组的总生育率相似（2.0对1.8；P = 0.27）。
结论
20 - 24岁患有林奇综合征的女性CRC幸存者年龄别生育率降低，但老年女性和男性未降低。
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