研究概要
去除重复后(筛选了 n = 1535 条记录),对 156 篇全文文章进行了资格评估;
中文摘要
男性性腺功能减退与代谢和心血管合并症相关,新出现的证据提示睾酮缺乏与免疫失调有关,而免疫失调可能升高癌症风险。综述关于男性性腺功能减退、免疫功能与癌症风险之间关系的当前证据,重点关注将睾酮缺乏与免疫抑制及肿瘤学结局联系起来的机制。系统检索了 PubMed/MEDLINE、Google Scholar 和 SciSpace(截至 2026 年 4 月),使用预设检索式。去除重复后(筛选 n = 1535 条记录),评估了 156 篇全文文章的合格性;20 项研究符合预设纳入标准(包括 4 项实验研究、4 项前瞻性/RCT 研究、7 项观察性研究,以及 5 篇作为二次文献使用的综述),并纳入叙述性综合。睾酮缺乏一致地与 IL-6、TNF-、IL-1 和 CRP 升高、中性粒细胞成熟受损以及 NK 细胞细胞毒性降低相关。在 prostate cancer 模型中,雄激素剥夺增强了胸腺输出和抗肿瘤 T 细胞反应,但在其他情境中促进了慢性炎症。在流行病学上,低睾酮与 colorectal cancer 风险增加以及晚期恶性肿瘤生存较差相关;prostate cancer 的关系遵循矛盾的饱和模型。性腺功能减退的免疫学后果具有情境依赖性。睾酮缺乏驱动可能促进癌变的促炎信号传导,而雄激素介导的免疫抑制可矛盾性地损害抗肿瘤监视。通过免疫抑制,性腺功能减退与癌症风险之间不存在简单的线性关系。需要前瞻性研究来指导性腺功能减退男性睾酮替代治疗的临床决策。
展开英文摘要原文
Male hypogonadism is associated with metabolic and cardiovascular comorbidities, and emerging evidence implicates testosterone deficiency in immune dysregulation that may elevate cancer risk. To review current evidence on the relationship between male hypogonadism, immune function, and cancer risk, focusing on mechanisms linking testosterone deficiency to immune suppression and oncologic outcomes. PubMed/MEDLINE, Google Scholar, and SciSpace were systematically searched (through April 2026) using predefined search strings. After removal of duplicates ( n = 1535 records screened), 156 full-text articles were assessed for eligibility; 20 studies met predefined inclusion criteria (comprising 4 experimental studies, 4 prospective/RCT studies, 7 observational studies, and 5 reviews used as secondary literature) and were included in a narrative synthesis. Testosterone deficiency was consistently associated with elevated IL-6, TNF- , IL-1 , and CRP, impaired neutrophil maturation, and reduced NK-cell cytotoxicity. Androgen deprivation augmented thymic output and anti-tumor T cell responses in prostate cancer models, yet promoted chronic inflammation in other contexts. Epidemiologically, low testosterone correlated with increased colorectal cancer risk and poorer survival in advanced malignancies; the prostate cancer relationship followed a paradoxical saturation model. The immunological consequences of hypogonadism are context-dependent. Testosterone deficiency drives pro-inflammatory signaling that may promote carcinogenesis, while androgen-mediated immunosuppression can paradoxically impair anti-tumor surveillance. No simple linear relationship exists between hypogonadism and cancer risk via immune suppression. Prospective studies are needed to guide clinical decisions on testosterone replacement therapy in hypogonadal men.
论文信息
- 作者
- La Vignera S、Condorelli RA
- 单位
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.Italy
- 文献类型
- 综述
- 期刊
- International journal of molecular sciences2026 Jul 18