https://scholars.lib.ntu.edu.tw/handle/123456789/458778
標題: | The biochemical and pathological correlates of successful semen cryopreservation from patients with testicular cancer: A single tertiary center experience | 作者: | Pong Y.-H. Kao M.-H. YU-CHUAN LU Lee I.C.-Y. Hsieh J.-T. Tsai V.F.S. HONG-CHIANG CHANG |
公開日期: | 2016 | 卷: | 88 | 起(迄)頁: | 76-80 | 來源出版物: | Urology | 摘要: | Objective To determine the predictors for success with regard to semen cryopreservation and good semen quality of patients with testicular cancer. Materials and Methods A total of 50 men (aged 16-36 years) with testicular cancer, referred for semen cryopreservation prior to gonadotoxic treatment, were included. Age, alpha fetal protein (α-FP), beta human chorionic gonadotropin, lactate dehydrogenase, clinical staging, tumor volume, and pathological reports were evaluated as correlates of successful semen cryopreservation and good semen quality. Results The overall success rate was 52%. α-FP (4113.1 ng/mL vs 81.2 ng/mL) and tumor volume (77.7 mL vs 25.5 mL) were significantly higher in the failure group as compared to the success group. The seminoma to nonseminomatous germ cell tumor ratio was lower in the failure group as compared to the success group (9/17 vs 3/21). There was nearly a significant difference (P =.066). The optimal cutoff value for α-FP > 1000 ng/mL showed the highest Youden index (0.689) and resulted in a sensitivity of 0.625 and specificity of 1.0 for predicting poor outcome. In terms of multivariate analysis, the α-FP (P =.013), tumor volume (P =.047), and α-FP > 1000 ng/mL (P =.010) were significantly associated with poor semen quality and failure to preserve semen. Sperm quality was found to be higher in the seminoma versus the nonseminomatous germ cell tumor patients in: sperm concentration (21.5 million/mL vs 11.8 million/mL, P <.027). Furthermore, tumor volume is correlated to α-FP (P =.018) and is weakly correlated to lactate dehydrogenase (P =.067) Conclusion Elevated α-FP and tumor volume are independently poor factors for semen quality and semen cryopreservation. In clinical use, α-FP is a noninvasive tool to predict the success of semen cryopreservation and patients with α-FP > 1000 ng/mL should be informed of the higher risk of poor semen quality and semen cryopreservation concerns. ? 2016 Elsevier Inc. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/458778 | DOI: | 10.1016/j.urology.2015.11.015 | SDG/關鍵字: | alpha fetoprotein; chorionic gonadotropin beta subunit; lactate dehydrogenase; alpha fetoprotein; adult; alpha fetoprotein blood level; Article; cancer size; cancer staging; controlled study; correlational study; cryopreservation; human; lactate dehydrogenase blood level; major clinical study; male; non seminomatous germinoma; outcome assessment; prediction; priority journal; seminoma; sperm preservation; sperm quality; spermatozoon density; testis cancer; Youden index; adolescent; biosynthesis; metabolism; neoplasm; retrospective study; semen analysis; seminoma; sperm; testis tumor; young adult; Adolescent; Adult; alpha-Fetoproteins; Cryopreservation; Humans; Male; Neoplasms, Germ Cell and Embryonal; Retrospective Studies; Semen; Semen Analysis; Seminoma; Testicular Neoplasms; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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