子宫内膜不典型增生和早期子宫内膜癌保守治疗方案分析

Analysis of Conservative Treatment Plans for Atypical Endometrial Hyperplasia and Early Endometrial Carcinoma

随着癌症发病的年轻化,患有子宫内膜癌的育龄期女性越来越多。为了保留生育能力,大部分患者倾向于保守治疗。故而众多研究者提出了子宫内膜不典型增生和早期子宫内膜癌的保守治疗方案,并在临床上进行了小样本研究。传统治疗以口服大剂量孕激素为主,然而多数口服孕激素治疗的患者复发率高、并发症多。左炔诺孕酮宫内缓释节育系统通过局部作用于子宫内膜,可减少大量孕激素对机体造成的不良反应。宫腔镜能够精准切除病灶,保护正常子宫内膜,相对降低了发生不孕、流产风险。二甲双胍的抗肿瘤作用能增加孕激素的有效率。通过综述子宫内膜不典型增生和早期子宫内膜癌各种保守治疗后的缓解率、复发率和妊娠结局,为临床上在治疗前对每位患者的自身因素及疾病特点进行评估,以采取对患者最有益的治疗方案及管理模式提供依据。

With the onset of cancer at a younger age,more and more women of childbearing age are suffering from endometrial cancer.In order to preserve fertility,most patients tend to conservative treatment.Therefore,many researchers have proposed conservative treatment plans for atypical endometrial hyperplasia and early endometrial cancer,and have been clinically studied in small samples.Traditional therapy is mainly oral high-dose progesterone.However,most patients with oral progesterone treatment have high recurrence rate and many complications.Levonorgestrel-releasing intrauterine system can reduce the side effects to the body caused by a large amout of progesterone through local effects on the endometrium.Hysteroscopy can precisely remove the lesion,protect the normal endometrium,and relatively reduce the risk of infertility and miscarriage in the later pregnancy.The anti-tumor effect of metformin can increase the effective rate of progesterone.Now,we summarizing relieving rate,recurrence rate,and pregnancy outcomes of the atypical endometrial hyperplasia and early endometrial cancer after various conservative treatments,in order to evaluate the own factors and disease characteristics of each patient before clinical treatment to choose the most beneficial treatment plan and management model for patients.