Son Kyung-A, Lee Dong-Yun, Choi DooSeok
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Front Endocrinol (Lausanne). 2019 Apr 11;10:235. doi: 10.3389/fendo.2019.00235. eCollection 2019.
Several preclinical and clinical studies have suggested that -mutation carriers may have decreased ovarian reserve. However, data in this area are limited and inconsistent, especially in young breast cancer patients. This study evaluated the association between mutation status and serum anti-Müllerian hormone (AMH) level in young, reproductive-aged patients with breast cancer. Patients ≤ 40 years of age with breast cancer and who had known status and baseline serum AMH level at Samsung Medical Center, Seoul, Korea, were considered for inclusion. A total of 52 mutation carriers (27 and 25 ) and 264 non-carriers were selected for analyses. The serum level of AMH was compared according to presence of a mutation, and linear and logistic regression analyses were performed to evaluate the association between mutation and serum AMH level. No difference was found in clinical characteristics between -mutation carriers and non-carriers. Subjects with any mutation had a significantly lower median AMH than those without a mutation (2.60 vs. 3.85 ng/mL, 32% reduction, = 0.004). Linear regression analysis showed a significant negative association between mutation and AMH level. In addition, logistic regression demonstrated non-significantly increased odds of mutation carriers having AMH < 1.2 ng/mL. However, no difference was found between mutations. Breast cancer patients with mutation have significantly lower serum AMH level. Fertility preservation should be considered more aggressively in young breast cancer patients with mutation.
多项临床前和临床研究表明,-突变携带者的卵巢储备功能可能会下降。然而,该领域的数据有限且不一致,尤其是在年轻乳腺癌患者中。本研究评估了年轻的育龄期乳腺癌患者的突变状态与血清抗苗勒管激素(AMH)水平之间的关联。纳入了年龄≤40岁、患有乳腺癌、已知在韩国首尔三星医疗中心的状态和基线血清AMH水平的患者。共选择了52名突变携带者(27名 和25名 )和264名非携带者进行分析。根据是否存在突变比较血清AMH水平,并进行线性和逻辑回归分析以评估突变与血清AMH水平之间的关联。突变携带者和非携带者的临床特征没有差异。任何突变的受试者的AMH中位数均显著低于无突变者(2.60 vs. 3.85 ng/mL,降低32%, = 0.004)。线性回归分析显示突变与AMH水平之间存在显著的负相关。此外,逻辑回归表明突变携带者AMH<1.2 ng/mL的几率增加但无统计学意义。然而, 突变之间没有差异。有突变的乳腺癌患者血清AMH水平显著较低。对于有突变的年轻乳腺癌患者,应更积极地考虑生育力保存。