子宫内膜癌保留卵巢功能的治疗对患者预后的影响

Effects of the ovary reservation thearpy on prognosis of patients with endometrial cancer

目的:探讨卵巢移位术辅以放疗和激素替代疗法对子宫内膜癌患者预后的影响。方法:选早期无转移的子宫内膜癌患者105例,按告知自愿的原则分A组(全切除组)、B组(卵巢保留组)、C组(卵巢保留+放疗组)、D组(卵巢保留+放疗+激素组)。A组30例,采用子宫全切除术治疗;B组25例,采用子宫全切除术+卵巢移位术治疗;C组34例,采用子宫全切除术+卵巢移位术+放射治疗;D组16例,采用子宫全切除术+卵巢移位术+放射+激素替代治疗。比较各组患者术后5年存活率、血清性激素水平及生活质量。结果:5年存活率比较,A组和B组无明显差异(P>0.05),C组和D组明显高于A、B组(P<0.01);血清性激素水平和临床表现比较,B、C和D组明显优于A组(P<0.01)。结论:对早期且无卵巢转移的子宫内膜癌的年轻患者采用子宫全切术+保留卵巢术,并辅以体外放疗+腔内放疗,或在术后进行激素替代治疗。

Objective： To explore the influence of ovary transposition with radiotherapy or hormone replacement therapy on the patients with endometrial cancer. Methods： 105 patients with endometrial cancer were divided into 4 groups. 30 cases as group A （total resection） underwent uterus total resection, 25 cases as group B（ovary reservation） underwent uterus total resection and transposition of ovary, 34 cases as group C（ovary reservation ＋ radiotherapy） underwent radiotherapy after the transposition of ovary, and 16 cases as group D （ovary reservation ＋ radiotherapy ＋ HRT ） were treated with hormone replacement therapy（HRT） after radiotherapy and ovary transposition. The flve-year survival rate, sex hormone level and clinical situation were compared. Results： The five-year survival rate had no difference between group A and B, while they were higher in group C and D than group A. The balances of serum sex hormone in group B, C and D were better than that in group A. And no patients had endocrine disorders in group B, C and D, such as skin roughness, obesity, hidrosis, and etc. Conclusion： Transposition of ovary assisted by radiotherapy or HRT is a good therapy for young patients with endometrial cancer.