Bandak M, Jørgensen N, Juul A, Lauritsen J, Kier M G G, Mortensen M S, Oturai P S, Mortensen J, Hojman P, Helge J W, Daugaard G
Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Andrology. 2017 Jul;5(4):718-724. doi: 10.1111/andr.12355. Epub 2017 Jun 9.
Testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to healthy controls. However, because of the fetal etiology of testicular cancer, familial unrelated healthy men might not be an optimal control group. The objective of this study was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross-sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular cancer survivors included, 24 had a biological brother who accepted to participate in the study. Serum levels of reproductive hormones and prevalence of metabolic syndrome according to International Diabetes Federation Criteria and National Cholesterol Education Program (Adult Treatment Panel III) criteria comprised the main outcome measures of the study. Median age was similar in testicular cancer survivors and their biological brothers [44 years (IQR 39-50) vs. 46 (40-53) years respectively (p = 0.1)]. In testicular cancer survivors, follow-up since treatment was 12 years (7-19). Serum levels of luteinizing hormone and follicle-stimulating hormone were elevated (p ≤ 0.001), while total testosterone, free testosterone, inhibin B and anti-Müllerian hormone were lower (p ≤ 0.001) in testicular cancer survivors than in their biological brothers. The prevalence of metabolic syndrome was similar and apart from HDL-cholesterol, which was lower in testicular cancer survivors (p = 0.01); there were no differences in the individual components of the metabolic syndrome between testicular cancer survivors and their brothers. In conclusion, gonadal function was impaired in testicular cancer survivors, while we did not detect any difference in the prevalence of metabolic syndrome between testicular cancer survivors and their biological brothers.
与健康对照组相比，睾丸癌幸存者存在性腺功能受损以及代谢综合征风险增加的情况。然而，由于睾丸癌的胎儿期病因，家族中无血缘关系的健康男性可能并非最佳对照组。本研究的目的是明确与他们的亲兄弟相比，睾丸癌幸存者是否存在性腺功能受损以及代谢综合征风险增加的情况。2014年至2016年对睾丸癌幸存者进行了一项横断面研究（ClinicalTrials.gov编号，NCT02240966）。在纳入的158名睾丸癌幸存者中，有24人的亲兄弟同意参与该研究。根据国际糖尿病联盟标准和美国国家胆固醇教育计划（成人治疗小组III）标准测定的生殖激素血清水平以及代谢综合征患病率构成了本研究的主要结局指标。睾丸癌幸存者及其亲兄弟的年龄中位数相似[分别为44岁（四分位间距39 - 50岁）和46岁（40 - 53岁）（p = 0.1）]。睾丸癌幸存者自治疗后的随访时间为12年（7 - 19年）。与他们的亲兄弟相比，睾丸癌幸存者的促黄体生成素和促卵泡生成素血清水平升高（p≤0.001），而总睾酮、游离睾酮、抑制素B和抗苗勒管激素水平较低（p≤0.001）。代谢综合征的患病率相似，除了睾丸癌幸存者的高密度脂蛋白胆固醇较低外（p = 0.01）；睾丸癌幸存者与其兄弟之间代谢综合征的各个组成部分没有差异。总之，睾丸癌幸存者的性腺功能受损，而我们未检测到睾丸癌幸存者与其亲兄弟之间代谢综合征患病率存在任何差异。
