{"id":212,"title":"Time-dependent anti-Müllerian hormone dynamics during GnRHa-based endocrine therapy in young breast cancer survivors: a longitudinal real-world cohort study","title_zh":"年轻乳腺癌幸存者基于GnRHa内分泌治疗期间抗苗勒管激素的时间依赖性动态：一项纵向真实世界队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42963797","doi":"10.1186/s13058-026-02359-9","pmid":"42963797","journal":"Breast Cancer Res","kind":"paper","lang":"en","published_at":"2026-08-04T00:00:00+00:00","fetched_at":"2026-11-08T03:43:57+00:00","authors":["Jiang C","Bi X","Hua X","Yuan Z","Guo Y","Wang S","Shi Y","Xu F","Zhong Y","Xue C"],"primary_topic":"repro-endo","topics":[{"slug":"repro-endo","score":5.0,"hits":["amh","anti-müllerian"]},{"slug":"oocyte","score":2.0,"hits":["ovarian","ovarian reserve"]},{"slug":"art-clinical","score":1.0,"hits":["gonadotropin"]}],"topic_score":5.0,"preference_score":0.0,"preference_labels":[],"llm_score":80.0,"final_score":80.0,"score_dims":{"novelty":72,"rigor":82,"impact":75,"relevance":78,"translation":80},"recommend_reason":"大样本纵向真实世界数据明确了GnRHa治疗背景下AMH的时间依赖性轨迹，对年轻乳腺癌患者生育力保存咨询与卵巢储备评估有直接参考价值；单中心回顾性设计限制机制推断。","keywords":["抗苗勒管激素","GnRHa","乳腺癌","卵巢储备","生育力保存","纵向队列"],"selected":1,"story_id":473,"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":"该回顾性纵向队列纳入2019—2024年中山大学肿瘤防治中心40岁前诊断的早期乳腺癌女性685例、共1758次AMH检测，按化疗暴露及GnRHa内分泌治疗分为四组，采用线性混合效应模型联合限制性立方样条分析log-AMH纵向轨迹。结果显示组别与时间交互显著，不同治疗背景的AMH轨迹不同；未化疗者用与不用GnRHa差异不显著；化疗者中GnRHa组12和36个月预测AMH较低，后期差异减弱。提示GnRHa暴露期间AMH应结合治疗时点与纵向变化解读，而非孤立判断卵巢储备。","summary":"BACKGROUND: Anti-Müllerian hormone (AMH) is widely used to assess ovarian reserve in young women with breast cancer. However, its interpretation during gonadotropin-releasing hormone agonist (GnRHa)-based endocrine therapy remains challenging because pharmacologic ovarian suppression may alter AMH levels over time. We aimed to characterize longitudinal AMH dynamics according to chemotherapy exposure and subsequent GnRHa-based endocrine therapy. METHODS: We conducted a retrospective longitudinal cohort study of women diagnosed with early breast cancer before age 40 at Sun Yat-sen University Cancer Center between August 2019 and December 2024. Patients were categorized into four groups according to chemotherapy exposure and GnRHa-based endocrine therapy. Longitudinal trajectories of log-transformed AMH were modeled using linear mixed-effects models with restricted cubic splines, adjusting for prespecified clinical covariates. Sensitivity analyses included baseline-AMH adjustment and exclusion of observations with extreme standardized residuals. RESULTS: The full cohort included 685 women contributing 1758 AMH measurements. The adjusted complete-case model included 613 women contributing 1602 measurements. The group-by-time interaction was significant (likelihood ratio χ2 = 249.33, df = 9, P < 0.001), demonstrating distinct AMH trajectories across treatment groups. Among women without chemotherapy, predicted AMH did not differ significantly between those with and without GnRHa-based endocrine therapy. Among chemotherapy-treated patients, the GnRHa-based endocrine therapy group was associated with lower predicted AMH at 12 and 36 months, but the differences attenuated at later follow-up. Similar trajectory patterns were observed in sensitivity analyses. CONCLUSIONS: AMH trajectories during GnRHa-based endocrine therapy are time-dependent and influenced by treatment context. AMH measurements during GnRHa exposure should be interpreted in relation to treatment timing and longitudinal changes rather than as isolated indicators of ovarian reserve.","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}}