Relation between serum follicule stimulating hormone, luteinizing hormone levels and risk of breast cancer in patients with Klinefelter syndrome

Xu Lifang; Tong Fangfang; Tan Dailin

doi:10.3760/j.issn.1673-4777.2019.07.016

Abstract：Objective To investigate the predictive values of serum follicle stimulating hormone (FSH)and luteinizing hormone(LH) for the 5-year incidence of breast cancer in patients with Klinefelter syndrome(KS).Methods From June 2011 to June 2013,55 KS patients admitted to Qianjiang Central Hospital,Hubei Province were followed up for 5 years.According to the occurrence of breast cancer during follow-up,they were divided into breast cancer group (17 cases) and control group(38 cases).Maintenance dose of androgen,duration of medication,medication compliance (Morisky score),serum levels of sex hormone before and after treatment were recorded.Independent risk factors of breast cancer were analyzed by Cox regression.Receiver operating characteristic (ROC)curve was used to evaluate the diagnostic efficacy of indexes in predicting breast cancer.Results There were no statistical differences of androgen maintenance dose,duration of medication and Morisky score between groups (P ＞ 0.05).Levels of serum FSH and LH in breast cancer group were significantly higher than those in control group before treatment(both P ＜ 0.05).After treatment,levels of serum FSH and LH significantly decreased in both groups;the levels in breast cancer group were significantly higher than those control group (all P ＜ 0.05).Cox regression analysis showed that FSH and LH levels before medication were independent risk factors of the 5-year incidence of breast cancer (P ＜ 0.05).ROC curve showed that areas under curve of FSH and LH in predicting the 5-year incidence of breast cancer were 0.796 and 0.797;the optimal cut-off points were 30.663 U/L and 12.614 U/L;area under curve of combined diagnosis of FSH and LH was 0.907;the diagnostic efficacy of combined diagnosis was significantly higher than that of separate detections(P =0.047,0.045);the sensitivity of combined diagnosis (82.35％) was significantly higher than that of separate detections (both P ＜ 0.05).Conclusion Elevated pretherapy levels of serum FSH and LH indicate high risk of breast cancer in 5 years in patients diagnosed of KS.