摘要
目的观察乳腺癌患者长期服用三苯氧胺对子宫及子宫内膜的影响,并探讨子宫内膜增生的诊断和治疗。方法41例服用三苯氧胺的绝经后女性乳腺癌患者入组,定期行阴道B超。发现子宫内膜厚度≥8mm者行子宫内膜病理检查,并应用不同剂量的甲羟孕酮来治疗子宫内膜增生,甲羟孕酮10mg,每日1次,共10天,或倍恩片0.25g每日1次,共10天。结果应用阴道超声发现子宫内膜厚度≥8mm者共15例,8例行诊断性刮宫,子宫内膜增生6例。应用甲羟孕酮后增生的子宫内膜脱落,不同剂量的甲羟孕酮疗效无差异。本组发现子宫肌瘤6例,其中3例TAM治疗前存在子宫肌瘤,TAM治疗后使子宫肌瘤迅速增大和个数增多,另3例在TAM治疗后出现子宫肌瘤。结论长期服用三苯氧胺可使子宫内膜增生,应采用阴道超声定期检测。甲羟孕酮可使增生的子宫内膜脱落。
Objective To observe the influence on endometrial and ovary of the patients with breast cancer who administrated routinely with TAM and explore the diagnosis and treatment of endometrial hyperplasia. Methods Forty one breast cancer cases who were post-menopause and administrated with TAM were enrolled in this study, in which vaginal B-ultrasound were performed periodically and endometrial pathological biopsy was performed in the patients whose thickness of endometrial larger than 8mm. Different dosage of medroxyprogesterone acetate was administrated a day with the dosage of 10 milligram or a day with the dosage of 0.25 gram on the patients with endometrial hyperplasia and finished after ten days. Results By using B-ultrasound, the thickness of endometrial larger than 8mm were observed in 15 cases. Diagnostic clearance on endometrial were performed on 8 cases and 6 cases with endometrial hyperplasia and endometrial hyperplasia were treated by medroxyprogestrone .The effect of different dosage of medroxyprogesterone acetate had no difference. Myoma of uterus in 3 cases before treatment were observed rapidly increasing in size and number after TAM treatment and another 3 cases were observed occuring new myoma lesions of uterus. Conclusion Endometrial hyperplasia and myoma of uterus happen probably in the patients treated with TAM. Periodical vaginal B-ultrasound should be performed and endometrial hyperplasia may be treated by medroxyprogestrone .
出处
《现代肿瘤医学》
CAS
2005年第4期492-493,共2页
Journal of Modern Oncology
关键词
三苯氧胺
子宫内膜
甲羟孕酮
阴道B超
乳腺癌
tamoxifen
endometrium
medroxyprogestrone
vaginal B-ultrasound
breast cancer
