在化疗后恢复卵巢功能的标志物AMH:IPD元分析和系统审查
Charissa van Zwol-Janssens1, Mandy van M Rosmalen2, Joop S E Laven1
1Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Cancer treatment reviews
|December 25, 2025
概括
化疗前的抗穆勒尔激素 (AMH) 水平预测乳腺癌患者的卵巢功能恢复. 然而,高测定变异性使得无法确定优化内分泌治疗的可靠切断点.
科学领域:
- 在瘤学瘤学.
- 生殖内分泌学 生殖内分泌学
- 生物标志物研究 生物标志物研究
背景情况:
- 在绝经前乳腺癌患者的化疗经常导致临时或永久的缺血.
- 抗穆勒尔激素 (AMH) 是预测卵巢功能恢复的潜在生物标志物.
- 预测卵巢功能恢复对于指导内分泌治疗决策至关重要.
研究的目的:
- 评估化疗前抗米勒尔激素 (AMH) 水平对卵巢功能恢复的预测值.
- 确定AMH是否可以帮助在绝经前乳腺癌患者的内分泌治疗决策.
主要方法:
- 进行了系统性审查和个人患者数据 (IPD) 分析.
- 使用相关关键字进行了广泛的在线数据库搜索.
- 该研究协议已在PROSPERO (CRD42021233966) 登记.
主要成果:
- 十一项涉及1029名女性的研究将IPD纳入了分析.
- 在化疗前,在恢复卵巢功能的妇女中,AMH显着更高 (SMD 0.94).
- AMH表现出良好的预测能力 (AUC 0.79-0.83),但截止值有显著的变化,显示出高的虚假阴性率.
结论:
- 化疗前的AMH与乳腺癌患者的卵巢功能恢复有关.
- 由于试验间的高可变性,无法确定临床可靠的AMH切断值.
- 标准化AMH测定对于未来的研究来说是必要的,以确定优化内分泌治疗的可靠切断点.
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