A pilot study of predictive markers of chemotherapy-related amenorrhea among premenopausal women with early stage breast cancer
A pilot study of predictive markers of chemotherapy-related amenorrhea among premenopausal women with early stage breast cancer
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DOI：
10.1080/07357900701829777
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发表时间：
2008-01-01
影响因子：
2.4
通讯作者：
Blackwell, Kimberly
中科院分区：
文献类型：
--
作者：
Anders, Carey;Marcom, P. Kelly;Blackwell, Kimberly
背景：接受早期乳腺癌（ESBC）治疗的绝经前女性存在化疗相关性闭经（CRA）的风险。需要前瞻性验证的CRA预测标志物。患者和方法：对ESBC和计划化疗（闭经风险>= 25%）的绝经前妇女进行评估。在化疗前、化疗后、化疗后6个月和1年前瞻性评估促卵泡激素（FSH）、雌二醇、抑制素A和B、抗苗勒管激素（AMH）和生活质量（QOL），并与年龄和月经状态相关。CRA定义为化疗后1年无月经。结果：在分析时对44名妇女进行了评价。CRA女性的诊断时中位年龄和化疗后1年的FSH较高（分别为44岁[33-51] vs. 40岁[31-43]; p = 0.03; 39.8 vs. 5.0 mLU/mL，p = 0.0058）。化疗后1年，恢复月经的女性中位雌二醇较高（108.3 vs. 41.3 pg/mL，p = 0.01）。CRA女性患者化疗前抑制素B和AMH的中位数较低（分别为33.2 vs 108.8 pg/mL; p = 0.03; 0.16 vs 1.09 ng/mL，p = 0.02）。化疗前抑制素B（RR = 1.67，p = 0.15）和AMH（RR = 1.83，p = 0.05）水平较低的女性发生CRA的风险增加。在化疗前抑制素B和AMH值低于中位数的妇女中，CRA的发生率为87.5%。结论：结果表明，化疗前抑制素B和AMH是较低的妇女经历CRA和可能是预测CRA的绝经前妇女面临化疗ESBC。
Background: Premenopausal women treated for early stage breast cancer (ESBC) are at risk for chemotherapy-related amenorrhea (CRA). Prospectively-validated, predictive markers of CRA are needed. Patients and Methods: Premenopausal women with ESBC and planned chemotherapy (>= 25% risk of amenorrhea) were evaluated. Follicle stimulating hormone (FSH), estradiol, Inhibin A and B, anti-Mllerian hormone (AMH), and quality of life (QOL) were prospectively evaluated pre-, post-, 6 months and 1 year post-chemotherapy and correlated with age and menstrual status. CRA was defined as absence of menses 1 year post-chemotherapy. Results: Forty-four women were evaluated at the time of analysis. Median age at diagnosis and FSH 1 year post-chemotherapy were higher among women with CRA (44 yrs [33-51] vs. 40 yrs [31-43]; p = 0.03; 39.8 vs. 5.0 mLU/mL, p = 0.0058, respectively). Median estradiol 1 year post-chemotherapy was higher among women who resumed menses (108.3 vs. 41.3 pg/mL, p = 0.01). Pre-chemotherapy median Inhibin B and AMH were lower among women with CRA (33.2 vs. 108.8 pg/mL; p = 0.03; 0.16 vs. 1.09 ng/mL, p = 0.02, respectively). The risk of CRA was increased among women with lower pre-chemotherapy Inhibin B (RR = 1.67, p = 0.15) and AMH (RR = 1.83, p = 0.05). Amongst women whose pre-chemotherapy Inhibin B and AMH values were below the median, the incidence of CRA was 87.5%. Conclusions: Results indicate that pre-chemotherapy Inhibin B and AMH are lower among women experiencing CRA and may be predictive of CRA among premenopausal women facing chemotherapy for ESBC.