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林奇综合征子宫内膜癌患者的生育力保存及辅助生殖策略

Fertility preservation and assisted reproductive strategies in endometrial cancer patients with lynch syndrome.

作者信息

Liu Junhan, Zheng Ying, Liu Jianhong

机构信息

Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, Sichuan, China.

Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital of Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Oncol. 2025 Jul 21;15:1630301. doi: 10.3389/fonc.2025.1630301. eCollection 2025.

Abstract

Patients with LS-EC can be treated with progestin-based fertility-sparing treatment under close monitoring, and pregnancy is recommended as soon as possible after complete remission (CR) of the disease, with assisted reproduction, supplemented by PGT-M, to minimize the probability of inheritance of the disease in the offspring. Radical surgery for endometrial cancer is recommended as soon as possible after completion of childbearing to minimize recurrence. The role of assisted reproductive technologies (ART) and preimplantation genetic testing for monogenic disorders (PGT-M) was explored. For patients achieving CR, early initiation of ART, especially IVF with frozen-thawed embryo transfer (FET), was associated with improved reproductive outcomes. PGT-M proved valuable in preventing the transmission of pathogenic MMR variants to offspring. Early use of ART and integration of PGT-M are critical for maximizing reproductive success while minimizing oncologic and hereditary risks.

摘要

LS-EC患者可在密切监测下接受基于孕激素的保留生育功能治疗,疾病完全缓解(CR)后建议尽快妊娠,可采用辅助生殖技术,并辅以胚胎植入前单基因病遗传学检测(PGT-M),以降低子代遗传该病的概率。生育完成后,建议尽快行子宫内膜癌根治性手术,以降低复发风险。探讨了辅助生殖技术(ART)及胚胎植入前单基因病遗传学检测(PGT-M)的作用。对于达到CR的患者,早期启动ART,尤其是冻融胚胎移植(FET)的体外受精(IVF),与改善生殖结局相关。PGT-M在预防致病性错配修复(MMR)变异传递给子代方面被证明具有价值。早期使用ART并结合PGT-M对于在最大程度提高生殖成功率的同时最小化肿瘤学及遗传风险至关重要。

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本文引用的文献

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Gynecol Oncol. 2024 May;184:245-253. doi: 10.1016/j.ygyno.2024.02.002. Epub 2024 Mar 6.
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