摘要
目的探讨乳腺癌术后服用三苯氧胺(TAM)对女性患者子宫内膜的影响及相关影响因素。方法回顾分析2008年1月至2014年4月宁夏医科大学总医院76例乳腺癌术后服用三苯氧胺患者的临床资料。全部76例患者按照服用TAM前是否绝经分为绝经前组29例、绝经后组47例,按服用TAM时间不同分为≤5年组和>5年组,按TAM服用剂量不同分为10~20mg·d-1组、30mg·d-1组和40mg·d-1组,按照入院后B超监测下子宫内膜厚度不同分为<5mm组、5~8mm组和>8mm组,观察不同情况下子宫内膜的变化。结果76例患者中,因阴道流血就诊35例(46.05%);76例患者均诊刮,60例患者病理诊断为子宫内膜病变(78.95%);绝经前服药者子宫内膜病变发生率(62.07%,18/29)低于绝经后服药者(89.36%,42/47)(P<0.01);TAM服用时间>5年的患者子宫内膜癌发生率高于≤5年的患者(P<0.01)。不同子宫内膜厚度组别间子宫内膜癌的发生率存差异有统计学意义(P<0.01)。绝经后服药者内膜癌发生率高于绝经前服药者(χ2=3.975,P=0.046)。结论乳腺癌术后服用三苯氧胺会导致子宫内膜发生不同程度的病变,服药前绝经与否、服药时间及子宫内膜厚度均与子宫内膜病变的发生有关,应重视服药期间的随访复查。
Objective To investigate the impact and the related factors on endometrium of breast cancer patients after tamoxifen( TAM) taken,and to provide a help on clinic medication safety and monitoring. Methods A retrospective analysis of 76 cases with breast cancer after taking tamoxifen was performed from January2008 to April 2014 in General Hospital of Ningxia Medical University. All the patients were divided into menopausal group and postmenopausal group based on the menstrual condition and the subjects were divided into ≤5 years group and > 5 years group / 10 ~ 20 mg · d- 1,30mg·d- 1and 40 mg · d- 1group based on medication time and medication dose,respectively. According to the different endometrial thickness,all patients were devided into < 5mm goroup,5 ~ 8mmgroup and > 8mm group. Results 76 cases with breast cancer,35 cases see a doctor because of vaginal bleeding( 35 /76,46. 05%). According to the preoperative endometrial examination results and postoperative pathological results,60 patients( 78. 95%,60 /76) occurred endometrial lesions. Less endometrial lesions occurred in menopausal patients( 62. 09%,18 /29) than these occurred in the post- menopausal patients( 89. 36%,42 /47)( P < 0. 01). The patients who taken the TAM >5 years has a higer rate in endometria cancerationl than ≤5 years( P < 0. 01). There were statistical significance in endometrial disease rate between the different endometrial thickness groups( P < 0. 01). Conclusion Breast cancer after taking tamoxifen can cause different degrees of endometrial lesions. The menstrual status,the time of taking medicine and the endometrial thickness are all associated with the occurrence of endometrial lesions. The patients should pay attention to follow- up review during the drug.
出处
《宁夏医科大学学报》
2015年第5期516-519,共4页
Journal of Ningxia Medical University
关键词
乳腺癌
三苯氧胺
子宫内膜病变
breast cancer
tamoxifen
endometrial pathology
