{"id":144,"title":"Male gonadal function and cancer treatment: Current perspectives","title_zh":"男性性腺功能与癌症治疗：当前视角","url":"https://pubmed.ncbi.nlm.nih.gov/42990034","doi":"10.4111/icu.20260397","pmid":"42990034","journal":"Investig Clin Urol","kind":"paper","lang":"en","published_at":"2026-11-01T00:00:00+00:00","fetched_at":"2026-11-08T03:43:57+00:00","authors":["Chiba K","Miyake H"],"primary_topic":"male","topics":[{"slug":"male","score":5.0,"hits":["azoospermia","leydig","sperm","spermatogenesis","testicular"]},{"slug":"fertility-preservation","score":2.0,"hits":["fertility preservation","gonadotoxic"]},{"slug":"embryology-lab","score":1.0,"hits":["cryopreservation"]},{"slug":"repro-tox","score":1.0,"hits":["gonadotoxic"]}],"topic_score":5.0,"preference_score":0.0,"preference_labels":[],"llm_score":73.0,"final_score":73.0,"score_dims":{"novelty":55,"rigor":60,"impact":72,"relevance":88,"translation":78},"recommend_reason":"系统梳理癌症治疗对男性性腺功能与生育力的影响，兼顾传统治疗和新型靶向/免疫治疗，并对精子冻存、显微取精及长期内分泌随访给出临床提示，适合生殖医学与生育力保存相关读者浏览。","keywords":["男性性腺功能","癌症治疗","生育力保存","精子冻存","显微取精","Leydig细胞功能障碍"],"selected":1,"story_id":240,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-gametes","source_name":"PubMed · 配子与性腺","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该文为叙述性综述，讨论癌症本身及放疗、手术、细胞毒化疗、分子靶向药物和免疫检查点抑制剂对男性性腺功能的影响，重点涉及生精受损、Leydig细胞功能障碍，以及治疗后持续无精子症或性腺功能减退。作者强调，在性腺毒性治疗前进行精子冻存是生育力保存的基石；对部分治疗后持续无精子症的幸存者，可考虑显微取精；长期内分泌随访还应关注代偿性Leydig细胞功能不全。原文未提供原始数据。","summary":"Recent advances in cancer treatment have markedly improved survival outcomes, increasing the importance of long-term quality of life issues, including male gonadal function. Cancer-related gonadal dysfunction results from the combined effects of the malignancy itself and anticancer therapies and primarily manifests as impaired spermatogenesis, although Leydig cell dysfunction may also contribute to long-term endocrine sequelae. Conventional treatments, including radiotherapy, surgery, and cytotoxic chemotherapy, have well-established gonadotoxic effects, whereas the long-term reproductive and endocrine consequences of newer anticancer therapies, such as molecular targeted agents and immune checkpoint inhibitors, remain incompletely understood. Although recovery of spermatogenesis is possible in some patients, persistent azoospermia and compensated or overt hypogonadism may develop after treatment. Sperm cryopreservation before gonadotoxic therapy remains the cornerstone of fertility preservation and should be considered for all eligible patients. In selected cancer survivors with persistent post-treatment azoospermia, microdissection testicular sperm extraction may provide an opportunity for biological fatherhood. In addition, increasing evidence suggests that long-term endocrine follow-up should address not only overt testosterone deficiency but also compensated Leydig cell dysfunction. As oncological outcomes continue to improve, clinicians should strive not only to cure cancer but also to preserve the long-term reproductive and endocrine health of cancer survivors through individualized treatment strategies and survivorship care.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}