KRAS基因突变子宫内膜癌患者高效孕激素治疗后成功助孕1例病案报道

A successful case of assisted pregnancy after highly effective progestogen treatment for endometrial carcinoma patient with KRAS gene mutation

目的探讨KRAS基因突变子宫内膜癌患者保留生育功能治疗的疗效及助孕方案的选择。方法对1例KRAS基因突变子宫内膜癌患者保留生育功能治疗及助孕过程进行报道, 并对相关文献进行回顾性分析。结果患者经高效孕激素及宫腔放置左炔诺孕酮宫内释放系统(levonorgestrel-releasing intrauterine system, LNG-IUS)治疗20个月后达到完全缓解, 拮抗剂加来曲唑方案促排卵, 取出LNG-IUS后, 降调节后人工周期解冻囊胚移植妊娠并足月分娩一活女婴。结论 KRAS基因突变子宫内膜癌患者经联合治疗可达到完全缓解并生育, 但治疗周期长, 需严密监测病情变化。

Objective To explore the curative effect of fertility-preserving therapy for endometrial carcinoma patient with KRAS gene mutation and the choice of pregnancy-assisting strategy.Methods We reported the fertility-preserving treatment and pregnancy-assisted process of a case of endometrial carcinoma patient with KRAS gene mutation and analyzed the related literatures.Results After 20 months of treatment with highly effective progestogen and intrauterine levonorgestrel-releasing intrauterine system(LNG-IUS),the patient achieved complete remission.Antagonist plus letrozole was used to induce ovulation.After LNG-IUS was taken out,the pregnancy from blastocyst transfer was achieved after downregulation and artificial cycle,and a live baby girl was born at term.Conclusion Endometrial carcinoma patient with KRAS gene mutation can achieve complete remission and fertility after combined treatment,but the treatment period is long,therefore,it is necessary to closely monitor changes of the disease.