乳腺癌术后患者服用三苯氧胺与子宫内膜癌的关系  

THE ASSOCIATION BETWEEN TAMOXIFEN USE AND DEVELOPING ENDOMETRIAL CARCINOMA IN BREAST CANCER PATIENTS

作　　者：王银华[1,2] 雷艳春[1] 姜辉春 

机构地区：[1]牡丹江医学院附属红旗医院,黑龙江牡丹江157011 [2]黑龙江中医药大学 [3]牡丹江市肿瘤医院乳腺科,黑龙江牡丹江157011

出　　处：《牡丹江医学院学报》2008年第5期23-24,共2页Journal of Mudanjiang Medical University

基　　金：黑龙江省卫生厅科研项目(2004-029)

摘　　要：目的：（1）观察乳腺癌患者术后服用三苯氧胺（TAM）是否导致子宫内膜癌.（2）找出即兼顾乳腺癌疗效和避免子宫内膜癌发生的最佳治疗方案。方法：连续随访雌激素受体阳性服（TAM）的乳腺癌患者138例（服药组20mg／次／d）连续服用5a，并以同时期无TAM服药时的乳腺癌患者125例（为对照组）。结果：服药组出现子宫内膜病变32例（28．6％），对照组出现4例（3．8％），两组比较差异显著（P〈0．05）。服药组服TAM1a，2a未见子宫内膜癌，3a、4a、5a出现子宫内膜癌2、2、3例。对照组乳腺癌术后1a、2a未见子宫内膜癌，3a、4a、5a表现子宫内膜癌0、0、1例。结论：长期服用TAM可导致子宫内膜单纯性增长，息肉也可导致子宫内膜癌，相对危险系数为1．6—10．0，与服药时间呈正相关，因此，本文观察TAM最佳服用时间为2a，既不影响乳腺癌的疗效，又减少子宫内膜癌的发生。Objective： 1. Evaluate the risk of developing endometrial carcinoma in breast cancer women treated with Tamoxifen. 2. Searche the optimal therapeutic regimen for Tamoxifen use in breast cancer treatment. Methods：follow - up investigation was done in the breast cancer women positive with estrogen receptors, 138 cases had been treated with Taximofen for 5 years ,and as a con- trol group, another 125 cases without Taximofen treatment. Results：There were endometrial pathological changes seen in 32 cases （28. 6 % ） in TAM - treated group,while only 4 cases（3.8 %,） in control group （p 〈 0. 05）. Within 2 years after surgical treatment for breast cancer, no endometrial carcinoma developed in both groups,while during the period of time from the third year to fifth year, there were 2,2,3 cases in TAM - treated group and 0,0,1 cases in control group developed endometrial carcinoma （p 〉 0. 05 ） . Conclusion：Long - term use of TAM increased odds of endometrial hyperplasia and polyps further to cancer, the relative risk coefficient was 1.6 - 10. 0, showed positive correlation. The optimal period of time of taking TAM was 2 years, it had no significant effect on developing endometrial carcinoma in TAM - treated group.

关 键 词：三苯氧胺 乳腺癌 子宫内膜癌 病理 

分 类 号：R73[医药卫生—肿瘤]