左炔诺孕酮宫内缓释系统治疗早期子宫内膜样腺癌及子宫内膜不典型增生的临床疗效

Clinical efficacy of levonorgestrel-releasing intrauterine system in the treatment of early endometriod adenocarcinoma and endometrial atypical hyperplasia

目的探讨左炔诺孕酮宫内缓释系统(LNG-IUS)治疗早期子宫内膜样腺癌(EEC)及子宫内膜不典型增生(EAH)的临床疗效。方法收集采用LNG-IUS治疗的10例EEC患者及31例EAH患者的临床资料,分析其疗效、治疗后妊娠及复发情况。结果所有患者治疗12个月时的完全缓解(CR)率为100%;治疗3、6、9、12个月时的EEC患者及EAH患者CR率比较均无统计学差异(P>0.05)。治疗>3个月CR的EAH患者的月经紊乱比例高于治疗3个月CR者(P<0.05)。治疗后,妊娠并活产率为20.6%,复发率为7.3%。结论 LNG-IUS治疗EEC及EAH安全、有效,治疗后应积极助孕,减少复发。

Objective To investigate the clinical efficacy of levonorgestrel-releasing intrauterine system(LNG-IUS) in the treatment of early endometriod adenocarcinoma(EEC) and endometrial atypical hyperplasia(EAH).Methods The clinical data of 10 patients with EEC and 31 patients with EAH treated with LNG-IUS were collected.The outcome, pregnancy and recurrence after treatment were analyzed.Results The complete remission(CR) rate of all the patients was 100% after treatment for 12 months.There were no significant differences in the CR rates treated for 3,6,9 and 12 months between EEC patients and EAH patients(P>0.05).The proportion of EAH patients with menstrual disorder and CR after treatment for more than 3 months was higher than that of EAH patients with menstrual disorder and CR after treatment for within 3 months(P<0.05).After treatment, the pregnancy live birth rate was 20.6% and the recurrence rate was 7.3%.ConclusionLNG-IUS is safe and effective in the treatment of EEC and EAH.Attention should be paid to active pregnancy assistance to reduce the recurrence after treatment.