激素治疗对围绝经期及绝经期妇女乳腺的病理影响——附乳腺穿刺病理91例分析

The effect of hormone repeal therapy in perimenopausal or postmenopausal women on pathology of breast

目的:探讨应用激素治疗(HT)对围绝经及绝经期妇女乳腺的病理影响。方法:选择91例围绝经及绝经期妇女为研究对象,52例用HT治疗(HT组),予倍美力0.3 mg/d,安宫黄体酮6 mg/d×10天周期用药或2 mg/d连续联合用药,39例无性激素治疗史(对照组),彩超扫描乳腺并测量腺体的厚度、检测血流信号,多普勒超声取样,之后在其引导下对乳腺结节或增生部位进行粗针针芯活检穿刺,对取得的组织进行病理分析。结果:超声检测乳腺腺体厚度及血流阻力指数(P=0.918、P=0.146)、乳腺穿刺组织病理呈增生改变的(P=0.882),两组比较无显著性差异。再将以上妇女分成HT≥5年组、HT<5年组、对照围绝经组、对照绝经组进行分组分析。超声检查腺体厚度依次为:对照围绝经组>HT<5年组>HT≥5年组>对照绝经组,但乳腺腺体的厚度及检出血流比、血流阻力指数、乳腺穿刺组织病理呈增生改变的,四组间比较仍无显著性差异(P>0.05)。91例中无乳腺异常血流及乳腺上皮细胞非典型增生的病例。结论:应用低剂量的激素治疗对乳腺的血流无影响,对乳腺无促其增生作用。

Objective： To study the effect of hormone therapy in perimenopausai or postmenopausni women on pathology of breast. Methods： 91 cases of perimenopansal or postmenopausal women , among them, 52 eases took conjugates estrogens 0. 3 mg/d and combined cycle MPA 6 mg/d 10 d continuous MPA 2 HT 39 others administered HT control Thickness X mg/d or as group, never as group. of mammary glands and blood flow signal detected rate and RI were examined by high frequency CDFI, then a core needle biopsy was performed on a mass by ultrasound - guided. Tissue sample were interpreted by a pathologisL Results： Thickness of mammary glands and blood flow signal detected rate and RI were not significant difference , the result of pathology of tissue sample were also no difference between two groups. 91 cases were divided into four groups for further： HT≥5 years, HT 〈5 years, control perimenopause, control postmenopause. The results shown that thickness of mammary glands of control perimenopause was slighdy higher than control postmenopausal group and HT 〈 5 years, the thickness of control postmenopause was the thinnest. But the thickness of mammary glands and blood flow signal detected rate and RI and breast histopathology were not significance. There were no cases to be found in rich blood flow signal and atypical hyperplasia in two groups. Conclusion： Mammary glands blood flow signal and RI are not affected by low dosage HT. It has not abnormal hyperplasia change on breast.