在Salpingo-Oophorectomy之后,携带BRCA1和BRCA2致病变体的携带者骨密度的变化
Leslie N Chan1, Lee-May Chen, Mindy Goldman
1School of Medicine, the Department of Obstetrics, Gynecology and Reproductive Sciences, the Helen Diller Family Comprehensive Cancer Center, the Department of Medicine, and the Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, San Francisco, California; the Division of Gynecology Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Facing Our Risk of Cancer Empowered, Tampa, Florida.
在34-50岁的BRCA1/2携带者中,降低风险的卵管切除术 (RRSO) 与卵巢保护相比,导致显著的骨损失. 激素治疗可以减轻但不能消除这种骨损失.
科学领域:
- 在瘤学瘤学.
- 遗传学 遗传学 是一个
- 内分泌学 在内分泌学.
背景情况:
- 患有BRCA1或BRCA2 (BRCA1/2) 致病变体的女性患卵巢癌和乳腺癌的风险增加.
- 降低风险的卵管切除术 (RRSO) 是一种手术选择,可以降低这些女性的癌症风险.
- 在患有BRCA1/2变异的绝经前妇女中,RRSO对骨矿物密度 (BMD) 的影响尚未完全理解.
研究的目的:
- 评估RRSO对34-50岁妇女的骨质量变化的影响,这些妇女患有BRCA1/2致病变体.
- 为了比较经过RRSO的女性和卵巢保护的对照组之间的BMD变化.
- 为了评估激素使用和RRSO后的BMD变化之间的关联.
主要方法:
- 对91名患有BRCA1/2变异的34-50岁女性进行前性队列研究 (PROSper).
- 在3年的RRSO组 (n=40) 和非RRSO对照组 (n=51) 之间的比较.
- 在基线,12个月和36个月用DXA测量BMD;使用多变量线性回归分析.
主要成果:
- 在RRSO后12个月和36个月观察到脊椎和部BMD显著下降 (-3.78%至 -5.71%脊椎, -2.96%至 -5.19%部).
- 在非RRSO组中,与基线相比,没有显著的BMD变化.
- 在RRSO组中使用激素与较少的骨损失有关,但并没有完全预防骨损失.
结论:
- 在绝经前的BRCA1/2携带者 (<50岁) 中,与卵巢保存相比,RRSO会导致临床上显著的骨损失.
- 激素治疗可以减少,但不能消除RRSO后的骨损失.
- 建议对接受RRSO的女性进行常规的BMD查,以管理骨质损失.
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