中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2019, Vol. 48 ›› Issue (1): 62-65.doi: 10.12007/j.issn.0258-4646.2019.01.013

• 论著 • 上一篇    下一篇

乳腺癌患者口服他莫昔芬后子宫内膜异常的临床意义

田东立, 李丰鑫, 邓雷, 宋斐然, 庞晓燕, 张颐   

  1. 中国医科大学附属第一医院妇科, 沈阳 110001
  • 收稿日期:2018-07-18 出版日期:2019-01-30 发布日期:2019-01-05
  • 通讯作者: 张颐 E-mail:syzi@163.com
  • 作者简介:田东立(1993-),女,硕士研究生.
  • 基金资助:
    沈阳市科技计划(17-231-1-54)

Clinical Significance of Endometrial Abnormalities in Patients with Breast Cancer after Oral Administration of Tamoxifen

TIAN Dongli, LI Fengxin, DENG Lei, SONG Feiran, PANG Xiaoyan, ZHANG Yi   

  1. Department of Gynecology, The First Hospital, China Medical University, Shenyang 110001, China
  • Received:2018-07-18 Online:2019-01-30 Published:2019-01-05

摘要: 目的 分析乳腺癌患者口服他莫昔芬(TAM)后子宫内膜异常的临床意义,探讨子宫内膜恶变的高危因素。方法 收集2011年9月至2017年12月中国医科大学附属第一医院收治的乳腺癌术后口服TAM因子宫内膜异常于妇科手术治疗的患者135例,根据术后病理将患者分为子宫内膜良性病变组(A组)和子宫内膜癌前病变及恶性病变组(B组)。比较2组患者年龄、绝经状态、体质量指数、子宫内膜厚度、异常子宫出血、口服TAM剂量、口服TAM时间、合并高血压及糖尿病等因素与子宫内膜恶变的关系。结果 A组患者124例,B组患者11例。2组比较,异常子宫出血发生率的差异有统计学意义(P<0.05),且为子宫内膜恶变的危险因素。结论 乳腺癌术后口服TAM出现异常子宫出血应警惕子宫内膜恶变,首选宫腔镜明确病变性质,无症状患者可随访观察。

关键词: 他莫昔芬, 子宫内膜病变, 异常子宫出血

Abstract: Objective To analyze the clinical significance of endometrial abnormalities in patients with breast cancer after oral administration of tamoxifen,and to determine the risk factors for endometrial malignancy. Methods We collected data from 135 patients with breast cancer who underwent surgery for endometrial abnormalities after oral administration of tamoxifen at the Department of Gynecology from September 2011 to December 2017. According to the pathological results obtained,the patients were divided into groups A (benign endometrial lesion) and B (precancerous and malignant endometrial lesion). The relationships between endometrial malignancy and factors including age,menopausal status,body mass index,endometrial thickness,abnormal uterine bleeding,oral dose of tamoxifen,duration of oral medication,and complications (hypertension and diabetes) were compared between the groups. Results There were 124 patients in group A and 11 patients in group B. The difference in the incidence of abnormal uterine bleeding,which was a risk factor for endometrial malignancy,was significant different between the groups (P<0.05). Conclusion Physicians should pay close attention to abnormal uterine bleeding in patients taking tamoxifen after surgery for breast cancer. Hysteroscopy should be used to confirm the nature of lesions,and patients without symptoms should be followed up.

Key words: tamoxifen, endometrial diseases, abnormal uterine bleeding

中图分类号: 

  • R711.32
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