性发育差异的个体的淋巴切除术 - 对于谁,什么时候,为什么,为什么不?
Sabine E Hannema1, Michele A O'Connell2
1Dept. of Paediatric Endocrinology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands.
概括
性发育差异 (DSD) 的个人面临癌症风险增加. 淋巴切除术可以预防癌症,但决策需要仔细评估风险和益处,优先考虑个人参与.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
背景情况:
- 性发育差异 (DSD) 会增加淋巴细胞生殖细胞癌症的风险.
- 淋巴切除术是一种预防措施,但具有诸如内分泌功能受损和生育能力等风险.
- 在DSD中评估个体癌症风险和淋巴腺功能是复杂的.
研究的目的:
- 描述一种全面的方法来评估性腺功能和DSD中的癌症风险.
- 在DSD中权衡预防性淋巴切除术的益处和危害.
- 为了告知有关淋巴切除术的决策,考虑替代方案和个人偏好.
主要方法:
- 对DSD,生殖细胞癌症风险和淋巴切除术的现有证据的审查.
- 描述淋巴腺功能和癌症风险的综合评估策略.
- 讨论诸如监视和GnRH类比治疗等替代方案.
主要成果:
- 在DSD中对淋巴腺功能和癌症风险的个别评估仍然具有挑战性.
- 目前的DSD癌症监测方法在灵敏度和特异性方面存在局限性.
- GnRH模拟治疗可以抑制不必要的性类固醇生产.
结论:
- 在DSD中预防性淋巴切除术的决定需要平衡癌症预防与潜在危害.
- 参与个体的共同决策对于淋巴切除术的选择至关重要.
- 推迟淋巴切除术,直到个体能够参与决策,往往是可取的,除非医学上禁忌.
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