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辅助生殖增加男性患前列腺癌风险
作者:小柯机器人 发布时间:2019/9/26 13:45:18

瑞典隆德大学Yahia AI-Jebari小组研究发现,通过辅助生殖生育的男性患前列腺癌的风险增加。相关论文2019年9月25日在线发表于国际顶尖医学期刊《英国医学杂志》。

研究组在瑞典进行了一项基于国家注册的队列研究。1994年1月至2014年12月,1181490名婴儿顺利出生,均为单胎,他们的父亲按照受孕方式的生育状况进行分组,其中体外受精(IVF)20618例,单精子卵胞浆显微注射(ICSI)14882例,自然受孕1145990例。

通过IVF、ICSI和自然受孕生育的父亲中分别有77例(0.37%)、63例(0.42%)和3244例(0.28%)被诊断为前列腺癌,平均发病年龄分别为55.9岁、55.1岁和57.1岁。与自然受孕相比,通过辅助生殖当上父亲的男性患前列腺癌的风险显著增加,ICSI风险比为1.64,IVF风险比为1.33;55岁之前患病的风险亦显著增加,ICSI风险比为1.86,IVF风险比为1.51。通过ICSI生殖并患上前列腺癌的父亲还不得不接受较大剂量的雄激素剥夺治疗。

通过辅助生殖技术(尤其是ICSI)获得父亲身份的男性,其早发前列腺癌的风险显著增加。这可作为一项风险因子,用于帮助监测和长期随访前列腺癌。

附:英文原文

Title: Risk of prostate cancer for men fathering through assisted reproduction: nationwide population based register study

Author: Yahia Al-Jebari, Angel Elenkov, Elin Wirestrand, Indra Schütz, Aleksander Giwercman, Yvonne Lundberg Giwercman

Issue&Volume: 2019/09/25

Abstract: 

Objective To compare the risk and severity of prostate cancer between men achieving fatherhood by assisted reproduction and men conceiving naturally.

Design National register based cohort study.

Setting Sweden from January 1994 to December 2014.

Participants 1 181 490 children born alive in Sweden during 1994-2014 to the same number of fathers. Fathers were grouped according to fertility status by mode of conception: 20 618 by in vitro fertilisation (IVF), 14 882 by intra-cytoplasmic sperm injection (ICSI), and 1 145 990 by natural conception.

Main outcome measures Prostate cancer diagnosis, age of onset, and androgen deprivation therapy (serving as proxy for advanced or metastatic malignancy).

Results Among men achieving fatherhood by IVF, by ICSI, and by non-assisted means, 77 (0.37%), 63 (0.42%), and 3244 (0.28%), respectively, were diagnosed as having prostate cancer. Mean age at onset was 55.9, 55.1, and 57.1 years, respectively. Men who became fathers through assisted reproduction had a statistically significantly increased risk of prostate cancer compared with men who conceived naturally (hazard ratio 1.64, 95% confidence interval 1.25 to 2.15, for ICSI; 1.33, 1.06 to 1.66, for IVF). They also had an increased risk of early onset disease (that is, diagnosis before age 55 years) (hazard ratio 1.86, 1.25 to 2.77, for ICSI; 1.51, 1.09 to 2.08, for IVF). Fathers who conceived through ICSI and developed prostate cancer received androgen deprivation therapy to at least the same extent as the reference group (odds ratio 1.91; P=0.07).

Conclusions Men who achieved fatherhood through assisted reproduction techniques, particularly through ICSI, are at increased risk for early onset prostate cancer and thus constitute a risk group in which testing and careful long term follow-up for prostate cancer may be beneficial.

DOI: 10.1136/bmj.l5214

Source: https://www.bmj.com/content/366/bmj.l5214

期刊信息

BMJ-British Medical Journal:《英国医学杂志》,创刊于1840年。隶属于BMJ出版集团,最新IF:27.604
官方网址:http://www.bmj.com/
投稿链接:https://mc.manuscriptcentral.com/bmj