雌激素替代治疗对生育期卵巢恶性肿瘤及宫颈癌患者预后的影响

Hormone replacement therapy(HRT) in women with a prior diagnosis of ovarian and cervical cancer

目的观察激素替代治疗(HRT)对卵巢与宫颈恶性肿瘤预后的影响。方法1999年8月至2003年6月对广西医科大学肿瘤医院的31例卵巢恶性肿瘤和34例子宫颈癌患者术后或放疗后进行HRT,同时选择同期收治的年龄、临床期别和病理类型大致相同的44例卵巢恶性肿瘤和49例子宫颈癌作为对照。使用倍美力片或尼尔雌醇加安宫黄体酮作为HRT方法。采用Kaplan-Meier生存曲线Log-Rank分析法,COX比例风险模型,对随访数据进行分析。结果HRT和非HRT两组在各临床病理因素间相比较,差异无显著性(P>0·05)。HRT和非HRT两组妇科恶性肿瘤复发或转移病例间相比较,差异无显著性(P>0·05)。Kaplan-Meier生存曲线Log-Rank分析,两组患者的生存期比较差异无显著性(P>0·05)。经COX比例风险模型分析,HRT不是影响生育期卵巢恶性肿瘤和宫颈癌预后的因素。结论HRT对卵巢恶性肿瘤和宫颈癌的预后无明显不良影响。

Object To explore the effects of the hormone replacement therapy on the prognosis of women with ovarian and cervical cancer. Methods From Aug. 1999 to Jun. 2003 hormone replacement therapy was conducted in 31 patients with ovarian cancer and 34 cases of cervical cancer after surgery or radiotherapy in the Tumor Hospital of Guangxi Medical University, and 44 cases of ovarian cancer and 49 cases with cervical cancer as controls. The survival curve of KaplanMeier and Log-Rank test as well as scale risk of COX model were used to analyse the relationship between hormone replacement therapy and prognosis of ovarian or cervical cancer. Results There was no difference in clinical-pathology of patients with or without HRT（P 〉 0. 05）. There was no difference in the numbers of recurrence or metastasis of patients with or without HRT（ P 〉 0. 05 ）. The results of Log-Rank test showed that there was no difference in survival curve of patients with or without HRT（P 〉 0. 05 ）. The results of scale risk of COX model also showed that HRT was not an independent prognosis factor for patients with HRT. Conclusion There is no negative influence in using HRT on patients with ovarian or cervical cancer after surgery or radiotherapy.