化疗对围绝经期妇女乳腺癌患者性激素水平的影响

Effect of chemotherapy on the sex hormone levels in perimenopause women with breast cancer

目的：探讨化疗对围绝经期妇女乳腺癌患者性激素水平的影响。方法：选取90例围绝经期乳腺癌术后患者为研究对象，乳腺癌孕激素受体（PR）、雌激素受体（ER）阳性为观察组服用三苯氧胺（TAM），PR、ER阴性为对照组不服用TAM，采用化学发光法测定血清黄体生成素（LH）、卵泡刺激素（FSH）、雌二醇（E2）水平，多普勒超声仪检查绝经前后子宫内膜厚度、宫腔深度，宫腔镜对观察组进行分段诊刮后进行病理检查，观察绝经前后子宫内膜病理改变情况。结果：观察组LH、FSH水平低于对照组，E2水平高于对照组，差异有统计学意义（P〈0．05）；绝经前后子宫内膜厚度及宫腔深度比较，差异无统计学意义（P〉0．05）；绝经前患者内膜息肉、内膜癌、单纯增生、不典型增生发生率明显少于绝经后患者，差异有统计学意义（P〈0．05）。结论：乳腺癌围绝经期妇女处于一个特殊内分泌环境，服用TAM期间应定期检测性激素水平，B超和宫腔镜了解子宫内膜厚度及病理变化，以指导临床用药。

Objective： To explore the effects of chemotherapy on the sex hormone levels in perimenopause women with breast cancer. Methods： A total of 90 perimenopause women after breast cancer surgery who were admitted in our hospital were included in the study. Those whose PR and ER were positive were served as the observation group and were given TAM. Those whose PR and ER were negative were served as the control group and were not given TAM. The chemiluminescence method was used to determine the levels of LH, FSH, and E2. The Doppler ultrasound device was used to measure the endometrial thickness and intrauterine depth before and after menopause. After fractional curettage by hysteroscopy, the patients in the observation group were performed with pathological examinations. The pathological change of endometrium before and after menopause was observed. Results： LH and FSH levels in the observation group were significantly lower than those in the control group, while Ez level was significantly higher than that in the control group （P〈0.05）. The comparison of endometrial thickness and intrauterine depth before and after menopause was not statistically significant （P〉0.05）. The occurrence rate of endometrial polyps, endometrial carcinoma, simple hyperplasia, and atypical hyperplasia in patients before menopause was significantly less than that in patients after menopause （P〈0.05）. Conclusions： Due to be in a special endocrine environment, during TAM administration period for perimenopause women with breast cancer, a regular determination of sex hormone levels, adoption of B ultrasound and hysteroscope to detect the endometrial thickness and pathological change are required in order to guide the clinical medication.