精原细胞瘤放疗前后精子性染色体数目异常的研究  

Study on the numerical abnormalities of sex chromosome in sperm of seminoma patients before and after radiotherapy

作　　者：桂亚平[1] 钱君海 乐威[1] 吴登龙[1] 章劲夫[1,3] 

机构地区：[1]上海市同济医院泌尿外科,上海200065 [2]浙江省宁波市第一人民医院肾脏泌尿中心 [3]上海市奉城医院

出　　处：《中国男科学杂志》2012年第12期30-33,共4页Chinese Journal of Andrology

基　　金：上海市科委引导项目资助（09411960100）;上海市教委创新重点项目资助（09ZZ31）

摘　　要：目的分析1例育龄男性睾丸精原细胞瘤术前和放疗后精子性染色体数目异常情况，评估其生殖遗传风险。方法收集患者手术前、术后放疗前和术后放疗2个月后的精子标本，运用荧光原位杂交技术对其精子性染色体进行分析，检测性染色体数目异常情况，并对三组精子性染色体数目异常率进行比较统计学分析。结果计数35722个精子，三组X精子和Y精子比率均接近1：1。放疗后精子性染色体数目异常率较放疗前组有显著上升（XX类型：0．148％versus0．294％，P〈0．05；XY类型：0．274％versus0．588％，P〈0．001；YY类型：0．187％versus0．354％，P〈0．05）；而术前组和术后组精子数目异常率比较差异无统计学意义，YY类型有差异（0．081versus0．187，P〈0．05）。结论放疗是造成精子性染色体数目异常率增高的主要因素，对于放疗后要求生育的患者，其子代有较高的生殖遗传风险。对于此类患者，建议准备怀孕前进行精子染色体数目FIsH评估，同时进行产前诊断或胚胎着床前诊断，以有助于优生优育，减少生殖遗传风险。Objective To analyze the numerical abnormalities of sex chromosome in sperm of seminoma patients before and after radiotherapy and evaluate its reproduction risks. Methods Fluorescence in situ hybridization （FISH） was preformed to detect the number of sex chromosome in sperm samples harvested from a seminoma patient before and after radiotherapy and before operation. Statistical analysis was carried out to evaluate the sex chromosomal numerical abnormalities between three groups. Results Sum of 35722 sperm cells were counted, the ratio of the X- bearing and Y-bearing sperm cells was closely to 1：1 in three groups, respectively. The incidence of sex chromosomal abnormal combinations （XX, XY, YY） were significantly increased in the post-radiotherapy group compared with that before radiotherapy group （0.294% versus 0.148%, P〈0.05; 0.588% versus 0.274%, P〈0.001; 0.354% versus 0.187%, P〈0.05, respectively）. Only YY-typed difference was significant between pre-operation and post-operation groups （0.187 versus 0.081, P〈0.05）, whereas no significance in total sex chromosome numerical abnormalities between two groups. Conclusion Increased incidence of sex chromosomal numerical abnormalities and high risks of reproductive and genetic disease was suggested in patients who underwent the radiotherapy treatment in the present study. FISH test is recommended to evaluate the rate of chromosomal numerical abnormalities; PGD and prenatal diagnosis are advised to increase the likelihood of a successful pregnancy.

关 键 词：精原细胞瘤 放射疗法 精子 性染色体畸变 

分 类 号：R737.23[医药卫生—肿瘤] R596.12[医药卫生—临床医学]