地屈孕酮、甲羟孕酮在早期子宫内膜癌宫腔镜电切术后患者中的应用

Application of Dydrogesterone and Medroxyprogesterone in Patients after Hysteroscopic Electrocision for Early Endometrial Cancer

目的:探究及比较地屈孕酮、甲羟孕酮在早期子宫内膜癌患者宫腔镜电切术后的应用效果及对肿瘤标志物、性激素的影响。方法:将2020年1月—2021年6月泉州东南医院的80例早期子宫内膜癌拟行宫腔镜电切术患者根据随机数字表法分为A组(40例)和B组(40例)。A组采用地屈孕酮进行治疗,B组则采用甲羟孕酮进行治疗。比较两组的治疗总有效率、不良反应发生率、术后不同时间的复发率、肿瘤标志物[血清糖类抗原125(CA125)、糖类抗原19-9(CA19-9)及人附睾蛋白4(HE4)]及性激素[血清雌二醇(E_(2))、孕酮(P)及黄体生成素/卵泡刺激素(LH/FSH)]。结果:B组的治疗总有效率显著高于A组,差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异均无统计学意义(P>0.05)。术后6、12及24个月B组的复发率均显著低于A组,差异均有统计学意义(P<0.05)。术前,两组的肿瘤标志物及性激素比较,差异均无统计学意义(P>0.05);术后3、6个月,B组的肿瘤标志物及E_(2)、LH/FSH均显著低于A组,P则均显著高于A组,差异均有统计学意义(P<0.05)。结论:甲羟孕酮在早期子宫内膜癌患者宫腔镜电切术后的应用效果显著优于地屈孕酮,且可显著改善患者的肿瘤标志物及性激素,因此甲羟孕酮在早期子宫内膜癌患者中的应用价值相对较高。

Objective:To investigate and compare the application effect of Dydrogesterone and Medroxyprogesterone in patients after hysteroscopic electrocision for early endometrial cancer and influence on tumor markers and sex hormones.Method:A total of 80 patients with early endometrial cancer who were scheduled to undergo hysteroscopic electrocision in Quanzhou Southeast Hospital from January 2020 to June 2021 were divided into group A(40 cases)and group B(40 cases)according to the random number table method.The group A was treated with Dydrogesterone,and the group B was treated with Medroxyprogesterone.Then the total effective rates of treatment,the incidence of adverse reaction,recurrence rates at different time after the operation,tumor markers[serum carbohydrate antigen 125(CA125),carbohydrate antigen19-9(CA19-9)and human epididymis protein 4(HE4)]and sex hormones[serum estradiol(E_(2)),progesterone(P)and luteinizing hormone/follicle stimulating hormone(LH/FSH)]of two groups were compared.Result:The total effective rate of treatment in group B was significantly higher than that in group A,the difference was statistically significant(P<0.05).The incidences of adverse reaction in two groups were compared,the differences were not statistically significant(P>0.05).The recurrence rates of group B at the sixth and twelfth and twenty-fourth month after the operation were significantly lower than those of group A,the differences were statistically significant(P<0.05).Before the operation,the tumor markers and sex hormones of two groups were compared,the differences were not statistically significant(P>0.05);at the third and sixth month after the operation,the tumor markers and E_(2),LH/FSH of group B were significantly lower than those of group A,the P were significantly higher than those of group A,the differences were statistically significant(P<0.05).Conclusion:The application effect of Medroxyprogesterone in patients with hysteroscopic electrocision for early endometrial cancer is better than those of Dydrogesterone,and it can significantly improve the tumor markers and sex hormones of patients,so the application value of Medroxyprogesterone in patients with hysteroscopic electrocision for early endometrial cancer is relatively higher.