Diagnostic and predictive accuracy of anti-mullerian hormone for ovarian function after chemotherapy in premenopausal women with early breast cancer.
Diagnostic and predictive accuracy of anti-mullerian hormone for ovarian function after chemotherapy in premenopausal women with early breast cancer.
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DOI：
10.1007/s10549-021-06508-w
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发表时间：
2022-04
影响因子：
3.8
通讯作者：
Clatot F
中科院分区：
文献类型：
--
作者：
Anderson RA;Kelsey TW;Perdrix A;Olympios N;Duhamel O;Lambertini M;Clatot F
绝经前早期乳腺癌（eBC）女性化疗后卵巢功能丧失的准确诊断和预测对于未来生育和后续辅助卵巢抑制的临床决策非常重要。我们研究了抗苗勒管激素（AMH）作为血清生物标志物的价值。对206例年龄在40-45岁的绝经前妇女在化疗前和化疗后的一系列血液样本进行了AMH检测。分析AMH对化疗后30个月卵巢功能丧失的诊断准确性及AMH对化疗后6个月卵巢功能丧失的预测价值。未检测到AMH显示30个月时卵巢功能缺失的诊断准确性较高，AUROC为0.89（96%CI 0.84-0.94，P < 0.0001）。6个月时未检测到AMH与30个月时绝经期雌二醇水平的PPV为0.77。在多变量分析中，年龄、治疗前AMH和FSH以及紫杉烷治疗是显著的预测因子，在6个月时与AMH结合，AUROC为0.90（95%CI 0.86-0.94），PPV为0.79，用于30个月时卵巢功能丧失。用保留30%数据的随机森林模型进行验证，得到了类似的结果。AMH是40-45岁女性eBC化疗后卵巢功能缺乏的可靠诊断测试。化疗后AMH的早期分析可以很好地准确识别卵巢功能不能恢复的妇女。这些分析将有助于为开始化疗前绝经前妇女的辅助内分泌治疗决策提供信息。
Accurate diagnosis and prediction of loss of ovarian function after chemotherapy for premenopausal women with early breast cancer (eBC) is important for future fertility and clinical decisions regarding the need for subsequent adjuvant ovarian suppression. We have investigated the value of anti-mullerian hormone (AMH) as serum biomarker for this. AMH was measured in serial blood samples from 206 premenopausal women aged 40–45 years with eBC, before and at intervals after chemotherapy. The diagnostic accuracy of AMH for loss of ovarian function at 30 months after chemotherapy and the predictive value for that of AMH measurement at 6 months were analysed. Undetectable AMH showed a high diagnostic accuracy for absent ovarian function at 30 months with AUROC 0.89 (96% CI 0.84–0.94, P < 0.0001). PPV of undetectable AMH at 6 months for a menopausal estradiol level at 30 months was 0.77. In multivariate analysis age, pre-treatment AMH and FSH, and taxane treatment were significant predictors, and combined with AMH at 6 months, gave AUROC of 0.90 (95% CI 0.86–0.94), with PPV 0.79 for loss of ovarian function at 30 months. Validation by random forest models with 30% data retained gave similar results. AMH is a reliable diagnostic test for lack of ovarian function after chemotherapy in women aged 40–45 with eBC. Early analysis of AMH after chemotherapy allows identification of women who will not recover ovarian function with good accuracy. These analyses will help inform treatment decisions regarding adjuvant endocrine therapy in women who were premenopausal before starting chemotherapy.
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影响因子：
45.3
作者：
Lambertini, Matteo;Blondeaux, Eva;Del Mastro, Lucia
通讯作者：
Del Mastro, Lucia
影响因子：
6.7
作者：
Jacobson, Melanie H.;Mertens, Ann C.;Howards, Penelope P.
通讯作者：
Howards, Penelope P.
为绝经前乳腺癌调整辅助内分泌疗法。
DOI：
10.1056/nejmoa1803164
发表时间：
2018-07-12
期刊：
The New England journal of medicine
影响因子：
--
作者：
Francis PA;Pagani O;Fleming GF;Walley BA;Colleoni M;Láng I;Gómez HL;Tondini C;Ciruelos E;Burstein HJ;Bonnefoi HR;Bellet M;Martino S;Geyer CE Jr;Goetz MP;Stearns V;Pinotti G;Puglisi F;Spazzapan S;Climent MA;Pavesi L;Ruhstaller T;Davidson NE;Coleman R;Debled M;Buchholz S;Ingle JN;Winer EP;Maibach R;Rabaglio-Poretti M;Ruepp B;Di Leo A;Coates AS;Gelber RD;Goldhirsch A;Regan MM;SOFT and TEXT Investigators and the International Breast Cancer Study Group
通讯作者：
SOFT and TEXT Investigators and the International Breast Cancer Study Group
影响因子：
5.8
作者：
Barnabei, Agnese;Strigari, Lidia;Torino, Francesco
通讯作者：
Torino, Francesco
影响因子：
8.3
作者：
ESHRE Guideline Group on Female Fertility Preservation;Anderson RA;Amant F;Braat D;D'Angelo A;Chuva de Sousa Lopes SM;Demeestere I;Dwek S;Frith L;Lambertini M;Maslin C;Moura-Ramos M;Nogueira D;Rodriguez-Wallberg K;Vermeulen N
通讯作者：
Vermeulen N