子宫内膜复杂不典型增生及早期子宫内膜癌患者经高效孕激素治疗的预后分析

Prognosis of patients with endometrial complex atypical hyperplasia and early endometrial cancer treated by highly effective progestogen therapy

目的:分析子宫内膜复杂不典型增生及早期子宫内膜癌患者经高效孕激素治疗的预后情况.方法:回顾性分析2010年1月~2014年1月间在我院应用高效孕激素治疗的90例子宫内膜复杂不典型增生及早期子宫内膜癌患者的临床资料,评价其治疗反应,分析影响高效孕激素治疗获得完全反应的相关因素,并统计两组病理起效时间、病理完全反应时间、复发率、妊娠相关情况及不良反应发生率.结果:两种病理在治疗总反应率、病理起效时间、病理获得完全反应时间、复发率及宫外孕发生率上比较差异均无统计学意义,同时,所有患者均表现为轻度不良反应,不良反应发生率比较差异亦无统计学意义;但治疗获得完全反应患者BMI﹤30kg/m^2比例显著高于未获得完全反应患者;且子宫内膜复杂不典型增生患者中妊娠率、活产率均显著高于子宫内膜癌,未妊娠病例显著少于子宫内膜癌,差异有统计学意义.结论:高效孕激素治疗子宫内膜复杂不典型增生及早期子宫内膜癌有一定临床价值或能取得一定预后获益,仍值得临床进一步探究.

Objective To analyze the prognosis of patients with endometrial complex atypical hyperplasia and early endometrial cancer treated by highly effective progestogen therapy. Methods The clinical data of 90 patients with endometrial complex atypical hyperplasia and early endometrial cancer treated by highly effective progestogen therapy in the hospital from January 2010 to January 2014 were retrospectively analyzed. The treatment response was evaluated and related factors influencing the complete response were analyzed. The pathological onset time, pathological complete response time, recurrence rate, pregnancy-related conditions and the incidence of adverse reactions were statistically analyzed. Results There was no significant difference in the total response rate, pathological onset time, pathological complete response time, recurrence rate or the incidence of ectopic pregnancy between the two diseases. The adverse reactions were mild. The proportion of BMI < 30 kg/m^2 in patients with complete response was significantly higher than that in patients without complete response. The pregnancy rate and live birth rate in patients with endometrial complex atypical hyperplasia were significantly higher than those in patients with endometrial cancer. Cases without pregnancy were significantly fewer than those with endometrial cancer. Conclusion The highly effective progestogen therapy is of certain clinical value in the treatment of endometrial complex atypical hyperplasia and early endometrial cancer, which is worthy of further investigation.