摘要
目的：比较绝经前、后子宫内膜癌患者经三苯氧胺治疗后血清性激素，癌组织雌、孕激素受体及子宫内膜癌组织学的改变，探讨三苯氧胺治疗的作用机理及效果。方法：４０例确诊为子宫内膜癌的患者，分为绝经前组（２８例）及绝经后组（１２例），给予三苯氧胺每次２０ｍｇ，每天３次，口服１０天，观察血清性激素等指标的改变。结果：两组患者癌组织的病理组织学有一定程度改变，表现为癌细胞向分化好的方向发展，以核浆比例下降、核分裂相减少、核形态向圆形转变为特征。用药后，绝经前患者促卵泡刺激素升高，癌组织雌激素受体（ＥＲ）含量或升高或下降，孕激素受体（ＰＲ）含量增加。绝经后患者卵泡刺激素下降，癌组织ＥＲ、ＰＲ含量以增加为主。结论：三苯氧胺对子宫内膜癌有一定治疗效果。对绝经前患者，三苯氧胺表现为抗雌激素作用；对绝经后患者，则表现为弱雌激素样作用。
Objective:Toinvestigatetheroleoftamoxifeninthetreatmentofpre-andpost-menopausalpatientswithendometrialcarcinoma,itsmechanismandefects.Methods:Fortypatientsofendometrialcancerweredividedintopre-andpost-menopausalgroups.Eachgroupwastreatedwithoraltamoxifen20mgthreetimesperdayfor10days.Thechangesofserumlevelsofsexhormones,levelsofestrogenandprogesteronereceptor(ER,PR)incarcinomatisueaswelashistopathologicchangesfolowingtamoxifentreatmentswereobservedandcompared.Results:Histologicalchangesshowedthatthecelnucleustocelplasmaratiodecreased,thenuclearmitosesreducedandthenuclearshapevariedfromsticktocircular,indicatingatendencyofcancercelstowardsbeterdiferentiation.Forpre-menopausalpatients,folicle-stimulatinghormone(FSH)increased,theconcentrationofEReitherroseorwentdownwhilePRincreased.Forpost-menopausalpatients,FSHdecreased,theconcentrationsofERandPRweremainlyontheincrease.Conclusion:Tamoxifenwasefectiveintreatingpatientswithendometrialcancer.Forpre-menopausalpatients,itactedasanantioestrogen.Forpost-menopausalpatients,itactedasaweakoestrogen.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
1996年第2期83-85,共3页
Chinese Journal of Obstetrics and Gynecology
