School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
, Lubbock, TX, USA.
Hormones (Athens). 2020 Dec;19(4):497-504. doi: 10.1007/s42000-020-00241-7. Epub 2020 Oct 1.
Klinefelter syndrome (47,XXY) has a prevalence of approximately 1 in 500 males. It is a condition characterized by an extra X chromosome and is an underdiagnosed clinical entity. Inactivation of genes enables their escape from regulatory mechanisms, which can result in such classic physical manifestations as hypogonadism, gynecomastia, infertility, and various hormonal and physical abnormalities. While the endocrine manifestations of 47,XXY are well-known, the oncologic manifestations have received less attention. An association between cancer and 47,XXY has not as yet been clearly defined, with variability noted in the prevalence of different malignancies in 47,XXY patients. The mechanisms underlying these altered oncologic risks are still under debate. Some of the proposed explanations include hormone imbalance, developmental malfunctions, and failed DNA repair mechanisms. However, the recognition of the oncological associations linked to 47,XXY could be helpful. Screening measures in certain malignancies may enable an earlier diagnosis of 47,XXY and the implementation of more customized care in 47,XXY and the mosaic variants.. The data for this review was compiled from relevant PubMed articles published within the last three decades and organized based on cancer type.
克氏综合征(47,XXY)的患病率约为每 500 名男性中有 1 例。这是一种以额外的 X 染色体为特征的病症,是一种诊断不足的临床实体。基因失活使其逃避了调控机制,从而导致了诸如性腺功能减退症、男性乳房发育症、不育症以及各种激素和身体异常等典型的身体表现。虽然 47,XXY 的内分泌表现广为人知,但肿瘤学表现却受到较少关注。癌症与 47,XXY 之间的关联尚未明确界定,47,XXY 患者的不同恶性肿瘤的患病率存在差异。这些改变的肿瘤风险的机制仍存在争议。一些提出的解释包括激素失衡、发育功能障碍和失败的 DNA 修复机制。然而,认识到与 47,XXY 相关的肿瘤学关联可能会有所帮助。在某些恶性肿瘤中进行筛查措施可能能够更早地诊断出 47,XXY,并在 47,XXY 和镶嵌变体中实施更具针对性的护理。本综述的数据来自过去三十年中发表的相关 PubMed 文章,并根据癌症类型进行了组织。