乳腺癌患者生育力保护技术前沿进展

Advances in fertility preservation technology for patients with breast cancer

随着医学的进步以及乳腺癌治疗方式的增加,乳腺癌患者的生存率逐年提高,同时年轻女性对生育的要求也逐渐提高。但是随着肿瘤治疗,包括放疗、化疗以及内分泌治疗中造成的生育力下降,已经成为困扰女性乳腺癌患者的头号难题。本研究介绍乳腺癌治疗过程中对生育力的影响,以及在肿瘤治疗过程中如何保护患者生育力,同时介绍各种生育方法的优缺点。应用PubMed、中国知网以及万方数据库检索系统,以中文关键词“乳腺癌、生育力保护、胚胎冷冻、卵巢”和英文关键词“breast cancer、fertility preservation、fertility protection”,检索2017-01-01-2022-01-31发表的相关文献。纳入标准:(1)与乳腺癌患者生育保护技术有关的研究;(2)保护乳腺癌患者生育力的大型临床试验。排除标准:(1)非中文核心期刊和英文非SCI收录的文献;(2)作者所属单位为基层医院;(3)年份久远的临床临床试验。根据纳入和排除标准,最终27篇文献纳入分析。目前乳腺癌的生育力保护深受广大临床医生的关注,临床中常用的乳腺癌患者生育力保护技术包括胚胎冷冻、卵母细胞冷冻、卵母细胞体外成熟技术和卵巢组织冷冻等。其中胚胎冷冻是目前临床使用最广泛,而且技术最完善的生育力保护策略。在乳腺癌的全程治疗中,无论是化疗、内分泌治疗还是放疗,都会对卵巢功能造成损害,要及时尽早进行卵巢功能保护,以便保护患者的生育力,为以后的生育提供良好的机会。

With the progress of medicine and the increase of treatment methods for breast cancer,the survival rate of pa-tients with breast cancer has significantly improved,while young women's requirements for fertility have gradually in-creased.However,the decline of fertility,caused by tumor treatment,including radiotherapy,chemotherapy and endo-crine therapy,has become the number one problem for women with breast cancer.This study introduces the impact on fertility during the treatment of breast cancer,and how to protect the patient's fertility during the treatment of tumor,as well as the advantages and disadvantages of various fertility methods.Using Pubmed,China National Knowledge Infra-structure(CNKI)and Wanfang database retrieval system,relevant literature published from January 1,2017to January practice include embryo freezing,oocyte freezing,in vitro maturation of oocytes,ovarian tissue freezing,etc.Embryo freezing is the most widely used and technically well-developed fertility protection strategy in clinical practice.During the whole process of treatment of breast cancer,whether it is chemotherapy,endocrine therapy or radiotherapy,ovarian func-tion will be damaged.It is necessary to protect ovarian function as soon as possible to protect the fertility of patients and provide good opportunities for future fertility.