Anti-Müllerian hormone as a new marker of the individualized ovarian function suppression treatment in the young breast cancer patients

李华萍; 殷志强

doi:10.3969/j.issn.1007-3969.2015.12.011

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Anti-Müllerian hormone as a new marker of the individualized ovarian function suppression treatment in the young breast cancer patients

更新时间：2025-12-31

- Anti-Müllerian hormone as a new marker of the individualized ovarian function suppression treatment in the young breast cancer patients
- China Oncology Vol. 25, Issue 12, Pages: 983-988(2015)
- 作者机构：
  
  1. 上海市浦南医院妇产科,上海,200125
  2. 上海交通大学附属仁济医院乳腺科,上海,200001
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2015.12.011
  CLC：
- Published Online：03 February 2016，
  
  Published：03 February 2015
- 稿件说明：
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李华萍,郭　祯,殷志强,等. 抗米勒管激素用于年轻乳腺癌患者卵巢功能抑制个体化治疗的评价[J]. 中国癌症杂志, 2015, 25(12): 983-988.

李华萍, 殷志强. Anti-Müllerian hormone as a new marker of the individualized ovarian function suppression treatment in the young breast cancer patients[J]. China Oncology, 2015, 25(12): 983-988.
李华萍,郭　祯,殷志强,等. 抗米勒管激素用于年轻乳腺癌患者卵巢功能抑制个体化治疗的评价[J]. 中国癌症杂志, 2015, 25(12): 983-988. DOI： 10.3969/j.issn.1007-3969.2015.12.011.

李华萍, 殷志强. Anti-Müllerian hormone as a new marker of the individualized ovarian function suppression treatment in the young breast cancer patients[J]. China Oncology, 2015, 25(12): 983-988. DOI： 10.3969/j.issn.1007-3969.2015.12.011.

摘要

背景与目的：年轻乳腺癌患者应用促黄体生成素释放激素类似物戈舍瑞林治疗没有个体化用药方案，并缺乏临床可用的指导依据。该研究皆在探讨抗米勒管激素(anti-Müllerian hormone，AMH)在年轻乳腺癌患者卵巢功能抑制个体化治疗的评价作用。方法：选取2012年5月—2014年1月在上海交通大学附属仁济医院因雌激素受体(estrogen receptor，ER)和孕激素受体(progesterone receptor，PR)阳性的乳腺癌41例患者，术前随机分为戈舍瑞林6个疗程+化疗组(简称戈舍瑞林组)20例，化疗组21例，30例同年龄组健康妇女为正常对照组，随访(17.4±6.2)个月。观察两组治疗后的停经时间与复潮时间，于术前1个月、戈舍瑞林组或化疗组术后月经复潮后3、6个月检测AMH、促卵泡激素(follicle-stimulating hormone，FSH)和E

水平。正常对照组在相应时间段内检测AMH、FSH和E

水平。结果：3组患者的术前临床资料及术前FSH、E2水平差异均无统计学意义(P0.05)，乳腺癌患者术前AMH水平较正常对照组降低，差异有统计学意义(P=0.04)；戈舍瑞林组较化疗组停经时间更短，差异有统计学意义(P=0.00)；戈舍瑞林组较化疗组复潮时间更短，差异有统计学意义(P=0.00)；与正常对照组及术前比较，戈舍瑞林组及化疗组FSH、E

水平在5个测定时间的差异均无统计学意义(P0.05)；戈舍瑞林组及化疗组在5个测定时间的AMH水平均显著降低，差异均有统计学意义(P=0.00)，两组在复潮后3、6个月AMH水平逐渐上升，差异均有统计学意义(P0.05)；与化疗组相比，戈舍瑞林组的AMH水平下降明显，戈舍瑞林组的AMH水平在复潮6个月后比化疗组升高，差异均有统计学意义(P0.05)。结论：年轻乳腺患者在卵巢功能抑制治疗+化疗过程中，AMH较其他评价卵巢储备的指标明显下降，在其他指标恢复术前水平后仍提示卵巢受损，提示AMH可以作为评价年轻乳腺癌患者卵巢功能的指标，亦有可能成为戈舍瑞林个体化治疗的评价指标。

Abstract

Background and purpose: The young breast cancer patients were treated with goserelin without individualized regimen

and lack of available clinical marker. The aim of this study was to investigate the role of anti-Müllerian hormone (AMH) in evaluation of

individualized treatment of ovarian function suppression in the young breast cancer patients. Methods: Forty-one young patients with estrogen receptor (ER) and progesterone receptor (PR) positive breast cancer from May 2012 to Jan. 2014 were randomly divided into 2 groups to undergo radical resection of breast cancer. According to postoperative treatment

one group was treated with goserelin + chemotherapy (n=20)

and the other group received chemotherapy alone (n=21). Thirty female patients in the same age group were selected as normal control group. The time of menopause and menstrual recovery after the goserelin + chemotherapy or chemotherapy alone were observed in 2 groups. In early follicular phase (day 3-5) of the cycle preceding the operation and 3

6 courses after the goserelin + chemotherapy treatment or chemotherapy treatment

serum levels of AMH

FSH and E

were measured in 2 groups. Accordingly

serum levels of AMH

FSH and E

were evaluated as well in normal control group. Results: There were no significant differences in preoperative general conditions and preoperative serum FSH and E

levels among the 3 groups (P0.05). Compared with normal control group

the preoperative serum AMH levels of young breast cancer patients were decreased significantly (P=0.04). The menopause time and menstrual recovery time in 2 chemotherapy groups were significantly shorter than that in normal control group (P=0.00). Compared with normal control group and preoperative measurement

the differences in serum FSH and E

levels were not statistically significant in goserelin + chemotherapy group or chemotherapy alone group (P0.05). The serum AMH levels measured at different time points of the goserelin + chemotherapy group and chemotherapy alone group were decreased significantly (P0.05). Compared with the chemotherapy group

the serum AMH levels of the goserelin + chemotherapy group after 6 courses were significantly decreased

and then significantly increased 6 months after me

nstrual recovery (P0.05). Conclusion: This study demonstrated that the serum AMH levels were obviously decreased after the ovarian function suppression treatment and increased after the menstrual recovery compared with evaluation of other ovarian reserve index. The serum AMH level could suggest ovarian reserve damage even after ovarian function has recovered to the noticeable level. Thus

AMH could be used clinically to evaluate the ovarian reserve of breast cancer patients as a potential marker for the individualized ovarian function suppression treatment in young breast cancer patients.

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China Anti-Cancer Association Committee of Breast Cancer Society,

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Department of Medical Oncology, Fudan University Shanghai Cancer Center; Phase Ⅰ Clinical Trial Center, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University

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