42例乳腺癌患者服用三苯氧胺并发子宫内膜癌临床病理分析

Pathological analysis of 42 patients with tamoxifen associated endometrial cancer

目的观察乳腺癌患者服用三苯氧胺（TAM）后并发子宫内膜癌的临床病理特征，判断其与停用TAM时间的相关性。方法将青岛大学医学院附属医院2000年至2011年TAM相关子宫内膜癌42例按临床病理服药时间的长短分：A组，服用TAM低于12个月者，共22例；B组，服药超过12个月者，共20例；回顾性分析2组临床病理资料。结果患者确诊子宫内膜癌时年龄范围32～85岁。其中确诊乳腺癌年龄、体重指数、应用激素替代治疗、TAM单次剂量、持续时间、累积剂量并无明显差异；但确诊子宫内膜癌年龄、是否绝经及确诊2种癌的时间间隔及组织学类型、病理分期、肌层及宫颈浸润程度差异均有统计学意义（P〈0．05）。结论与A组相比，B组肿瘤病理分期级别更高，组织学类型更具有侵袭性，可能与B组年龄更大及包含更多的绝经患者相关。

Objective To study the clinicopathological features of endometrial cancer patients diagnosed during or after tamoxifen （TAM）treatment for breast cancer and to evaluate the relevance between the clinicopath- ological features and the cessation time of TAM treatment. Methods 42 TAM-related endometrial cancers pa- tients in the Affiliated Hospital of Medical Collage of Qingdao University were divided into 2 groups according to the cessation time of TAM. Group B were 20 past TAM users who were diagnosed as endometrial cancer 12 or more months since the cessation of TAM. Group A included the rest 22 patients. The clinicopathological features of the 2 groups were analyzed retrospectively. Results The age of patients was ranging from 32 to 85 years when they were diagnosed endometrial cancer. There was no significant difference in terms of the age at which breast cancer was diagnosed, BMI, HRT, single dose of TAM, duration and cumulative dose between the 2 groups. However, the difference of the age at which endometrial cancer was diagnosed, menopausal status, the interval between diagnostic date of the 2 cancers, histological types, pathological stage, myometrial invasion, and cervical invasion had statistical significance between the 2 groups （ P 〈 0. 05 ）. Conclusion Compared with group A, group B have a higher pathological stage and more invasive histological features, which may be because group B include more elderly and postmenopausal patients.