宫颈鳞癌行卵巢移位患者卵巢状况的研究

Study of Ovary Status in Patients with Cervical Squamous Cell Carcinoma with Ovarian Transposition

目的探讨宫颈鳞癌患者行卵巢移位术对卵巢功能变化的影响,及患者接受放疗后对移位卵巢内分泌功能的影响。方法选取宫颈鳞癌患者80例,均先行卵巢移位手术,医生依据患者自身恢复情况选择不同放疗方案,30例术后未进行放疗,另50例后续采用放疗方案。分析手术前后及放疗后3个月、6个月、12个月患者卵巢功能变化,并观察促卵泡成熟激素(FSH),促黄体激素(LH),雌二醇(E2)和潮热、多汗、阴道干涩等围绝经期症状指标。结果卵巢移位术并未影响宫颈鳞癌患者血清中FSH、LH和E2表达水平。与未放疗患者相比,术后放疗降低了宫颈鳞癌患者血清中FSH和LH表达水平,而上调了E2表达水平;对放疗患者进行周期性分析,结果显示,放疗3个月后,患者体内FSH和LH水平显著升高,E2表达水平显著下降,差异均具有统计学意义;放疗6个月后,FSH和LH水平高于术前而低于放疗3个月时表达水平,E2表达水平低于术前而高于放疗3个月表达水平;放疗12个月后,FSH和LH表达水平高于术前而低于放疗3个月和6个月,E2表达水平低于术前而高于放疗3个月和6个月。此外,放疗后3个月时,23例患者卵巢功能失调;随着放疗方案的进行,6个月时,失调人数下降为11例;12个月后,降为7例,其他43例患者卵巢功能均恢复正常。结论卵巢移位术结合放疗可以作为1种临床治疗宫颈鳞癌患者的策略。

Objective To investigate the effect of ovarian transposition surgery on the patients with cervical squamous cell carcinoma,and the ovary endocrine function of patients after radiotherapy. Methods 50 patients with cervical squamous cell carcinoma treated with ovarian transposition before radiotherapy and 30 patients without radiotherapy were enrolled for the study.Analysis changes of ovarian function before surgery and radiotherapy for 3 month,6 months and 12 months via observing follicle stimulating hormone（ FSH）,luteinizing hormone（ LH）,estradiol（ E2） and hot flushes / sweating / vaginal dryness and other symptoms of perimenopausal period index. Results Ovarian transposition did not affect the expression of FSH,LH and E2 in serum of patients with cervical squamous cell carcinoma. Compared with the patients did not received radiotherapy,radiotherapy reduced the expression of FSH and LH while elevated E2 expression in serum; analysis of the patients received radiotherapy after surgery,the results showed that radiotherapy affected the function of cervical in short time and then recovered in 12 months. Conclusion Ovarian transposition combined with radiotherapy should be regarded as a promising strategy for patients with cervical squamous cell carcinoma.