国际肿瘤学杂志 ›› 2013, Vol. 40 ›› Issue (8): 614-617.

• 综述 • 上一篇    下一篇

肿瘤治疗对女性生育力的影响及其机制和风险评估

廖彩韵, 梁晓燕   

  1. 510620广州,中山大学附属第六医院生殖医学研究中心
  • 出版日期:2013-08-08 发布日期:2013-08-15

Mechanisms and risk assessment of cancer treatment-induced female fertility impairment

LIAO  Cai-Yun, LIANG  Xiao-Yan   

  1. Reproductive Medicine Research Centre, 6th Affiliated Hospital, Sun Yat-sen University. Guangzhou 510620, China

  • Online:2013-08-08 Published:2013-08-15

摘要: 肿瘤的主要治疗方法包括手术、放疗和化疗。卵巢囊肿剔除由于常伴随正常卵巢皮质组织的损失,可导致术后不同程度的卵巢储备下降,其中卵巢子宫内膜异位囊肿剔除术尤其容易导致卵巢储备的受损。放疗、化疗通过卵巢各级细胞凋亡、削弱卵巢血供以及加速卵泡募集等机制导致卵巢储备迅速提前耗竭。此外,放疗还可能导致子宫结构和功能的改变,从而导致妊娠并发症发生率上升。卵巢储备是女性生育力的重要决定因素,而卵巢基础窦卵泡计数以及血清抗苗勒管激素是目前评估卵巢储备的较为灵敏、准确的方法。

关键词: 肿瘤, 生育力, 外科手术, 药物疗法, 放射疗法

Abstract: Surgical resection, radiotherapy and chemotherapy are the current mainstays of cancer treatments. During ovarian cystectomy, part of the normal ovarian cortex could be resected together with ovarian mass, which compromises ovarian reserve postoperatively. This reduction in ovarian reserve is especially pronounced after resection of ovarian endometriomas. On the other hand, radiotherapy and chemotherapy may cause apoptosis of the component cells, diminish blood supply in the ovaries and weaken the brake on follicular recruitment. Brought together, these mechanisms give rise to accelerated deprivation of ovarian follicles, and hence undermine fecundity of the affected individuals. Moreover, radiotherapy could result in alterations in structure and functions of uterus and other pelvic organs, which translate into increased incidence of obstetric complications later on. Currently antral follicular count and serum anti-Müllerian hormone are the most sensitive and accurate measurements of ovarian reserve.

Key words: Neoplasms, Fertility, Surgical procedures, operative, Drug therapy, Radiotherapy