宫腔镜电切术联合孕激素治疗早期孕激素受体阳性子宫内膜癌的疗效

Efficacy of Hysteroscopic Resection Combined with Progesterone in the Treatment of Early Progesterone Receptor-positive Endometrial Carcinoma

目的研究宫腔镜电切术联合孕激素治疗早期孕激素受体阳性子宫内膜癌的疗效。方法选取2018年1月~2020年1月我院诊治的60例早期孕激素受体阳性子宫内膜癌患者为研究对象,采用随机数字表法分为对照组和观察组,各30例。对照组采用宫腔镜电切术治疗,观察组在对照组基础上给予孕激素治疗,比较两组治疗总有效率、复发率、初诊至复发平均时间雌激素受体(ER)和孕激素受体(PR)阳性率、血清指标[CA125抗原、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平以及不良反应发生率。结果观察组治疗总有效率为93.33%,高于对照组的80.00%,差异有统计学意义(P<0.05);随访6个月,观察组复发率为6.67%,低于对照组的16.67%,差异有统计学意义(P<0.05);观察组初诊至复发平均时间长于对照组,ER、PR阳性率均高于对照组,差异有统计学意义(P<0.05);治疗后,两组CA125、TNF-α、IL-6均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);在治疗和观察期间,观察组不良反应发生率为10.00%,与对照组的6.67%比较,差异无统计学意义(P>0.05)。结论宫腔镜电切术联合孕激素治疗早期孕激素受体阳性子宫内膜癌可提高治疗总有效率,降低复发率,提高雌孕激素受体阳性率,降低CA125、TNF-α、IL-6水平,且不增加不良反应发生几率,应用安全有效。

Objective To study the curative effect of hysteroscopic resection combined with progesterone in the treatment of early progesterone receptor-positive endometrial cancer.Methods A total of 60 patients with early progesterone receptor-positive endometrial cancer diagnosed and treated in our hospital from January 2018 to January 2020 were selected as the research objects.They were divided into a control group and an observation group by random number table method,with 30 cases in each group.The control group was treated with hysteroscopic resection,and the observation group was treated with progesterone on the basis of the control group.The total effective rate,recurrence rate,mean time from first diagnosis to recurrence,positive rate of estrogen receptor(ER)and progesterone receptor(PR),serum indicators[CA125 antigen,tumor necrosis factor-α(TNF-α)]were compared between the two groups,Interleukin-6(IL-6)]levels and the incidence of adverse reactions.Results The total effective rate of treatment in the observation group was 93.33%,which was higher than 80.00%in the control group,the difference was statistically significant(P<0.05);After 6 months of follow-up,the recurrence rate of the observation group was 6.67%,which was lower than the 16.67%of the control group,the difference was statistically significant(P<0.05);The average time from first diagnosis to recurrence in the observation group was longer than that in the control group,and the positive rates of ER and PR were higher than those in the control group,the difference was statistically significant(P<0.05);After treatment,the levels of CA125,TNF-α,and IL-6 in the two groups were lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05);During the treatment and observation period,the incidence of adverse reactions in the observation group was 10.00%,compared with 6.67%in the control group,the difference was not statistically significant(P>0.05).Conclusion Hysteroscopic resection combined with progesterone in the treatment of early progesterone receptor-positive endometrial cancer can increase the total effective rate of treatment,reduce the recurrence rate,increase the positive rate of estrogen and progesterone receptors,and reduce CA125,TNF-α,and IL-6 level,and does not increase the probability of adverse reactions,the application is safe and effective.