Rajpert-De Meyts E, Skakkebaek N E
University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark.
Eur Urol. 1993;23(1):54-9; discussion 60-1. doi: 10.1159/000474570.
The peak incidence of testicular cancer in young men suggests that gestational development and events during early infancy and puberty are important in the pathogenesis of the disease. There are two potentially significant events: the transformation of fetal germ cells into carcinoma-in-situ cells (CIS) and later conversion of CIS cells into fully invasive cancer. Several hypotheses suggest an endocrinological background to testicular neoplasia. Based on epidemiological and experimental evidence, the possible role of oestrogens, androgens and gonadotrophins is discussed in this review. The role of Sertoli cells and the importance of interplay between endocrine and paracrine factors is also stressed.
年轻男性睾丸癌的发病率高峰表明,妊娠发育以及婴儿早期和青春期的事件在该疾病的发病机制中具有重要意义。有两个潜在的重要事件:胎儿生殖细胞转变为原位癌(CIS)细胞,以及随后CIS细胞转变为完全浸润性癌症。几种假说提示了睾丸肿瘤形成的内分泌学背景。基于流行病学和实验证据,本综述讨论了雌激素、雄激素和促性腺激素可能发挥的作用。还强调了支持细胞的作用以及内分泌和旁分泌因子之间相互作用的重要性。