Service de Gynécologie Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, CHRU, Lille F-59037 Cedex, France; EA 4308 Gamétogénèse et Qualité du Gamète, Centre Hospitalier Universitaire, Lille F-59037 Cedex, France.
Laboratoire de Biochimie and Hormonologie, Centre de Biologie Pathologie, CHRU, Lille F-59037 Cedex, France.
Reprod Biomed Online. 2018 Jun;36(6):711-718. doi: 10.1016/j.rbmo.2018.02.004. Epub 2018 Mar 2.
The relationship between early recovery of menstrual activity and blood anti-Müllerian hormone (AMH) concentrations were investigated within the first year post-chemotherapy in 32 young patients with breast cancer. All were treated by surgery and the same chemotherapy protocol (three cycles of FEC100 plus three cycles of taxanes). Menstrual activity, blood AMH (using picoAMH ELISA) and FSH concentrations were measured longitudinally before, during and up to 12 months after the end of chemotherapy (six samples per patient). Among the cohort, 17 patients recovered spontaneous cycles at +6 months (fast recovery) whereas the remaining 15 patients were still amenorrheic at that time (slow recovery). Blood AMH differed between these two subgroups at each time of the recovery phase starting at 3 months post-chemotherapy. The AMH patterns were also different: rapid and large increase in the fast recovery versus slow and partial increase in the slow recovery subgroup. No difference in ovarian recovery was observed between patients with a hormone positive or negative tumour. In conclusion, studying the post-chemotherapy patterns of menstrual activity and AMH, two paces of early ovarian recovery are distinguishable in young breast cancer patients who received the same chemotherapy protocol. This suggests different individual ovarian susceptibilities to chemotherapy.
本研究旨在探讨 32 例年轻乳腺癌患者化疗后 1 年内,早期恢复月经活动与血液抗苗勒管激素(AMH)浓度之间的关系。所有患者均接受手术和相同的化疗方案(3 个周期的 FEC100 联合 3 个周期的紫杉烷类药物)治疗。在化疗前、化疗期间和化疗结束后 12 个月内(每个患者 6 个样本),对月经活动、血液 AMH(采用 picoAMH ELISA 法)和 FSH 浓度进行了纵向测量。在该队列中,17 例患者在+6 个月时恢复自发周期(快速恢复),而其余 15 例患者在该时间仍闭经(缓慢恢复)。在恢复阶段的每个时间点,这两个亚组的血液 AMH 均存在差异。AMH 模式也不同:快速和大量增加(快速恢复)与缓慢和部分增加(缓慢恢复)。在激素阳性或阴性肿瘤患者之间,卵巢恢复无差异。结论:在接受相同化疗方案的年轻乳腺癌患者中,研究化疗后月经活动和 AMH 的模式可区分两种早期卵巢恢复速度。这表明个体对化疗的卵巢敏感性不同。