摘要
目的:分析宫腔镜病灶切除、促性腺激素释放激素激动剂(GnRHa)联合曼月乐治疗早期子宫内膜癌(EC)效果。方法:回顾性分析2014年6月-2019年6月就诊于本院行宫腔镜病灶切除术的EC患者105例病例资料,根据治疗方法分为对照组48例和观察组57例。对照组口服醋酸甲地孕酮联合GnRHa注射治疗,观察组放置曼月乐联合GnRHa注射治疗,观察比较两组疗效、肿瘤标记物、炎症因子、妊娠结局以及并发症发生情况。结果:105例术后3、6、9、12个月累计完全缓解率分别为60.0%、73.3%、81.0%、84.8%,两组后12月时完全缓解率(87.7%、81.3%)无差异(P>0.05),并发症发生率观察组(15.8%)低于对照组(33.3%)(P<0.05);105例随访时间(29.8±9.3)月,期间完全缓解的患者观察组50例,妊娠率17例(34.0%)(17/50),对照组39例,妊娠11例(28.2%),两组妊娠率无差异(P>0.05)。单变量COX回归分析,体质指数BMI<28 kg/m^(2)可缩短治疗后完全缓解时间(P=0.003);观察组治疗6个月后的雌孕激素受体水平、炎症因子指标及肿瘤标记物均低于对照组(均P<0.05)。结论:宫腔镜病灶切除、GnRHa联合曼月乐治疗早期子宫内膜癌预后良好,可降低不良反应,有一定临床应用前景,但需严格掌握治疗指征并定期随访。
Objective:To analyze the effect of hysteroscopic resection and gonadotropin-releasing hormone agonists(GnRHa)injection combined with levonorgestrel-intrauterine system(LNG-IUS)for treating patients with early endometrial cancer(EC).Methods:A total of 105patients with early EC from June 2014to June 2019were analyzed retrospectively.These patients were divided into control group(n=48)and observation group(n=57)according to different treatment methods.All patients had undergone hysteroscopic resection of the EC lesion,then the patients in the control group were treated with oral megestrol acetate combined with GnRHa injection,and the patients in the observation group were treated with LNG-IUS combined with GnRHa injection.The curative effect,the levels of tumor markers and inflammatory factors,the pregnancy outcomes,and the complications rate of the patients were observed and compared between the two groups.Results:The cumulative complete remission rate of these 105patients in 3,6,9,and 12months after operation were 60.0%,73.3%,81.0%,and 84.8%,respectively.There was no significant difference in the complete remission rate(87.7%vs.81.3%)of the patients in 12months after operation between the two groups(P>0.05).The complication rate(15.8%)of the patients in the observation group was significantly lower than that(33.3%)of the patients in the control group(P<0.05).105patients were followed up for 29.8±9.3 months,and during this period,there were 50patients with complete remission in the observation group with the pregnancy rate of 34.0%(17/50),and there were 39patients with complete remission in the control group with the pregnancy rate of 28.2%(11patients).The pregnancy rate of the patients had no significant difference between the two groups(P>0.05).Univariate COX regression analysis showed that the value of body mass index<28kg/m^(2) of the patients could shorten the time to complete remission after treatment(P=0.003).After 6months of treatment,the levels of estrogen receptor,the inflammatory factors,and the tumor m
作者
邢孔芸
邓岳红
麦燕
龚婷
XING Kongyun;DENG Yuehong;MAI Yan;GONG Ting(Sanya Central Hospital(Hainan Third People’s Hospital),Sanya Hainan Province,572000)
出处
《中国计划生育学杂志》
2023年第9期2229-2234,共6页
Chinese Journal of Family Planning
基金
海南省卫生计生行业科研项目(16A200038)。
关键词
早期子宫内膜癌
宫腔镜病灶切除
促性腺激素释放激素激动剂
曼月乐
临床疗效
术后妊娠
Early endometrial cancer
Hysteroscopic resection of lesion
Gonadotropin-releasing hormone agonists
Levonorgestrel-intrauterine device system
Clinical effect
Postoperative pregnancy
