Fatherhood and Sperm DNA Damage in Testicular Cancer Patients.
Fatherhood and Sperm DNA Damage in Testicular Cancer Patients.
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DOI：
10.3389/fendo.2018.00506
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发表时间：
2018
影响因子：
5.2
通讯作者：
Lombardo F
中科院分区：
文献类型：
--
作者：
Paoli D;Pallotti F;Lenzi A;Lombardo F
睾丸癌（TC）是所有恶性肿瘤中最可治疗的肿瘤之一，这些患者的生活质量管理越来越重要，特别是关于他们的性和生育能力。幸存者必须克服对生育能力下降和可能的妊娠相关风险以及对后代健康影响的焦虑和恐惧。因此，越来越多的人意识到需要为癌症幸存者提供生殖咨询。研究发现，与健康的、有生育能力的对照组相比，TC患者的精子DNA损伤水平较高，但这些患者与不育患者之间没有显著差异。由于癌症治疗导致的精子DNA改变在治疗结束后持续2至5年，并且可能受到治疗类型和疾病阶段的影响。人口研究报告称，TC幸存者的总体生育率略有下降，ART的使用频率高于一般人群，成功率约为50%。癌症诊断后的亲子关系是一个重要的问题，生殖潜力正在成为生活质量的一个主要因素。与基因组不稳定性相关的精子染色质不稳定性是与恶性肿瘤或其治疗相关的最重要的生殖副作用。研究这种损伤的程度可能在癌症患者的管理中具有相当大的翻译重要性，因为它们可以确定生殖细胞系修复核损伤所需的时间，从而产生后代风险降低的配子。
Testicular cancer (TC) is one of the most treatable of all malignancies and the management of the quality of life of these patients is increasingly important, especially with regard to their sexuality and fertility. Survivors must overcome anxiety and fears about reduced fertility and possible pregnancy-related risks as well as health effects in offspring. There is thus a growing awareness of the need for reproductive counseling of cancer survivors. Studies found a high level of sperm DNA damage in TC patients in comparison with healthy, fertile controls, but no significant difference between these patients and infertile patients. Sperm DNA alterations due to cancer treatment persist from 2 to 5 years after the end of the treatment and may be influenced by both the type of therapy and the stage of the disease. Population studies reported a slightly reduced overall fertility of TC survivors and a more frequent use of ART than the general population, with a success rate of around 50%. Paternity after a diagnosis of cancer is an important issue and reproductive potential is becoming a major quality of life factor. Sperm chromatin instability associated with genome instability is the most important reproductive side effect related to the malignancy or its treatment. Studies investigating the magnitude of this damage could have a considerable translational importance in the management of cancer patients, as they could identify the time needed for the germ cell line to repair nuclear damage and thus produce gametes with a reduced risk for the offspring.