子宫内膜癌术后性激素补充治疗的安全性分析

Analysis of Safety of Postoperative Hormone Replacement Therapy for Patients with Endometrial Cancer

目的分析子宫内膜癌术后性激素补充治疗的安全性。方法回顾分析子宫内膜癌患者60例的临床资料,根据患者术后是否行性激素补充治疗,分为HRT组20例,对照组40例,对照组接受常规放化疗治疗。对比分析2组患者治疗疗效影响因素以及治疗安全性。结果 COX多因素分析结果显示:激素使用、病理分期、病理分级以及孕激素受体是子宫内膜癌术后治疗疗效的独立危险因素。HRT组术后复发率、复发时间以及围绝经期症状改善情况分别为5.0%、(12.3±0.5)个月及20.0%,显著优于对照组术后复发率、复发时间以及围绝经期症状改善情况[12.5%、(9.4±0.3)个月及7.5%],差异显著(P<0.05)。2组患者治疗后均无乳腺肿瘤发生(P>0.05)。结论激素使用、患者病理分期、病理分级以及孕激素受体为子宫内膜癌治疗疗效的独立危险因素;子宫内膜癌术后性激素补充治疗可有效改善患者围绝经期症状,延长肿瘤复发时间,降低肿瘤复发率,临床上可推广使用。

Objective To analyze the safety of postoperative hormone replacement therapy for patients with endometrial cancer. Methods Clinical data of 60 patients with endometrial carcinoma were analyzed retrospectively, patients were into HRT group（20 cases） and the control group （40 cases） , according to whether the patients received hormone therapy. The control group received routine radiotherapy and chemotherapy, compare and analyze the influencing factors and the safety of the 2 groups. Results COX multi-factor analysis showed that the independent risk factors for endometrial cancer were hormone use, pathological stage, pathological grade and progesterone receptor. The postoperative recurrence rate, the recurrence time and the improvement of peri menopausal symptoms in patients with HRT were 5% , （12.3 ± 0.5） months and 20% , respectively, Compared with the recurrence rate, the recurrence time and the improvement of peri menopausal symptoms of the control group were 12.5 %, （9.4 ± 0.3 ） months and 7.5% , respectively;The difference was significant （P 〈 0.05 ）. No breast cancer occurred in the 2 groups after treatment （ P 〉 0.05 ）. Conclusion Hormone use, pathological stage, pathological grade and progesterone receptor are the independent risk factors for endometrial cancer;the postoperative hormone replacement therapy for endometrial cancer can effectively improve the symptoms of peri menopausal period, prolong the time of tumor recurrence, reduce the recurrence rate, and can be widely used in clinical practice.