宫腔镜手术前应用大剂量孕激素对子宫内膜癌患者肿瘤标志物及生存率的影响

Effect of high-dose progesterone on tumor markers and survival rate of patients with endometrial cancer before hysteroscopy

目的探讨宫腔镜手术前应用大剂量孕激素对子宫内膜癌患者肿瘤标志物及生存率的影响.方法将84例子宫内膜癌患者按照随机数字表法分为研究组与对照组,每组42例.两组均于宫腔镜手术前给予孕激素治疗,对照组给予标准剂量,观察组给予大剂量,随访5个月.比较两组临床疗效及术后5个月末患者生存率.比较治疗前及术后3d两组肿瘤标志物水平及炎性因子水平.结果 观察组治疗总有效率显著高于对照组(P<0.01),术后5个月末生存率显著高于对照组(P<0.05).术后3 d两组甲壳质酶蛋白40、鳞状细胞癌抗原、细胞角蛋白21-1片段、超敏-C反应蛋白、肿瘤坏死因子α及白细胞介素4水平均较治疗前显著降低(P<0.01),观察组较对照组下降更显著(P<0.01).结论宫腔镜手术前应用大剂量;孕激素可有效延长子宫内膜癌患者的生存期,降低肿瘤标志物及炎性因子水平,临床疗效显著.

Objective To investigate the effect of high-dose progesterone on tumor markers and survival rate of patients with endometrial cancer before hysteroscopy.Methods 84 patients with endometrial cancer were divided into research group and control group according to random number table method,42 cases in each group.Both groups were given progestin treatment before hysteroscopy,the control group was given standard dose,and the observation group was given high dose,followed up for 5 months.The clinical efficacy of the two groups was compared,and the survival rates of the two groups at the end of 5 months after surgery were compared.The levels of tumor markers and inflammatory factors were compared between the two groups before treatment and 3 days after surgery.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.01),and the survival rate at the end of 5 months was significantly higher than that in the control group(P<0.05).At 3 days after surgery,the levels of YKL-40,SCCAg,CYFRA21-1,hs-CRP,TNF-α,and IL-4 in the two groups were significantly lower than before treatment(P<0.01),and the observation group was more significantly reduced than the control group(P<0.01).Conclusions The application of highdose progesterone before hysteroscopic surgery can effectively prolong the survival time of patients with endometrial cancer,reduce the levels of tumor markers and inflammatory factors,and have a significant clinical effect.