title: Sperm DNA integrity in testicular cancer patients.
abstract: BACKGROUND
  We evaluated the impact of testicular germ cell cancer (TGCC), its treatment and length of follow-up on sperm DNA integrity.
  
  
  METHODS
  In 96 TGCC patients, semen was collected at specific intervals until 5 years after treatment. Sperm DNA integrity was assessed by the sperm chromatin structure assay (SCSA, n = 193) and by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling (TUNEL, n = 159) assay. Results were expressed as DNA fragmentation index (DFI). Controls comprised of 278 military conscripts.
  
  
  RESULTS
  Post-surgery testicular cancer (TC) patients did not differ from controls. Compared with pretreatment values, radiotherapy induced a transient increase in SCSA(DFI) (medians: 12 versus 19%; P = 0.03), normalizing after 3-5 years. One year or more after therapy, 5/13 (38%) of normozoospermic, irradiated patients had SCSA(DFI) >27% compared with 7% of normozoospermic controls (P = 0.002). More than two cycles of chemotherapy decreased DFI 3-5 years post-therapy (median SCSA(DFI): 12 versus 9.1%, P = 0.02; median TUNEL(DFI): 11 versus 7.5%, P = 0.03).
  
  
  CONCLUSIONS
  Irradiation increases sperm DNA damage 1-2 years after treatment, and 38% of irradiated patients with normozoospermia had high (>27%) DNA damage, which may affect the sperm-fertilizing ability. TC per se is not associated with an increase of DFI, and DFI is reduced by three or more cycles of chemotherapy.
authors.affiliation: Department of Oncology, Lund University Hospital, Lund, Sweden. olaf.sahl@med.lu.se
authors.forename: O
authors.initials: O
authors.lastname: Ståhl
authors.forename: J
authors.initials: J
authors.lastname: Eberhard
authors.forename: K
authors.initials: K
authors.lastname: Jepson
authors.forename: M
authors.initials: M
authors.lastname: Spano
authors.forename: M
authors.initials: M
authors.lastname: Cwikiel
authors.forename: E
authors.initials: E
authors.lastname: Cavallin-Ståhl
authors.forename: A
authors.initials: A
authors.lastname: Giwercman
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002843:Chromatin / Q000648:ultrastructure; D004249:DNA Damage; D006801:Humans; D020287:In Situ Nick-End Labeling; D008137:Longitudinal Studies; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000235:genetics* / Q000532:radiotherapy / Q000628:therapy*; D011832:Radiation Injuries / Q000235:genetics*; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors; D013094:Spermatozoa / Q000187:drug effects* / Q000528:radiation effects*; D013736:Testicular Neoplasms / Q000235:genetics* / Q000532:radiotherapy / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002843:Chromatin