绝经激素治疗在妇科恶性肿瘤中的研究进展

Progress of Menopausal Hormone Therapy in Gynecological Malignant Tumors

妇科三大恶性肿瘤即宫颈癌、子宫内膜癌和卵巢癌发病率逐年上升,并有年轻化趋势。许多患者因治疗妇科肿瘤而发生医源性绝经,迅速出现严重的绝经症状,生活质量下降。绝经激素治疗(menopausal hormone therapy,MHT)能有效控制更年期症状、减轻泌尿生殖道萎缩和预防骨质疏松。研究表明:对宫颈鳞癌、Ⅰ期子宫内膜癌和卵巢上皮性癌行MHT相对安全;不建议对宫颈腺癌、Ⅱ期及以上期别的子宫内膜癌、卵巢颗粒细胞瘤和低级别子宫内膜间质肉瘤行MHT。小剂量MHT在改善绝经症状同时具有较轻不良反应。有关MHT在妇科肿瘤患者中治疗优势的报道日益增多,但仍缺乏大规模研究。临床中应结合具体情况,行个体化MHT。MHT在妇科恶性肿瘤中的应用仍有待探索。

The morbidity of cervical cancer,endometrial cancer and ovarian cancer are increasing each year, and show younger trend. Many patients become iatrogenic menopause because of treating gynecologic cancer, show serious climacteric symptoms rapidly, and lead to lower quality of life. Menopausal hormone therapy（MHT） can control menopausal symptoms,relieve urogenital atrophy and prevent osteoporosis effectively. Studies indicate that it is relative safety for cervical squamous carcinoma,endometrial carcinoma of stage Ⅰ and ovarian epithelial carcinoma to receive MHT;cervical adenocarcinoma,endometrial carcinoma of stage Ⅱ and more than stage Ⅱ,granulose cell tumor of ovary and endometrial stromal sarcoma of low grade are not be suggested to receive MHT. Low dose MHT may have lighter adverse reactions while improve menopausal symptoms. The reports of the therapeutic advantages in gynecologic cancer patients increase day by day, but there have been no large-scale studies about it. In clinical use,we should give individual MHT combining with the situation. The application of MHT in gynecological malignant tumors is remained to be explored.