乳腺癌患者术后服用三苯氧胺后子宫内膜病变的临床病理分析  

Clinical and Pathologic Analysis of Endometrial Lesion in Postoperative Breast Cancer Patients Taking Tamoxifen

作　　者：袁芳[1] 王福玲[1] 马德花[1] 初怡静[1] 崔竹梅[1] 

机构地区：[1]青岛大学医学院附属医院东区妇科,山东青岛266000

出　　处：《肿瘤防治研究》2012年第8期970-972,共3页Cancer Research on Prevention and Treatment

摘　　要：目的分析乳腺癌患者术后服用三苯氧胺(tamoxifen,TAM)后子宫内膜的病理变化。方法研究组为服用TAM出现阴道不规则出血或B型超声提示子宫内膜异常患者69例;对照组为同时期非乳腺癌因绝经后出血就诊的患者60例。TAM组又分为绝经前、后两组(20例、49例)及根据服用TAM时间(T)长短,分为T≤1年组、1年<T<2年组、T≥2年组,进行宫腔镜检查及子宫内膜活检。结果TAM组子宫内膜息肉及子宫内膜增生明显高于对照组(P<0.001,P<0.05)。绝经后TAM组较绝经前TAM组更易发生子宫内膜病变(P<0.01),且子宫内膜重度不典型增生和子宫内膜癌均发生在绝经后组。随着用药时间的延长,子宫内膜病变的发生增加(P<0.01),且子宫内膜癌均发生在服药2年后。结论乳腺癌患者使用TAM治疗发生子宫内膜病变的风险增加,尤其对于绝经后使用且用药2年以上的妇女。Objective To evaluate the effect of tamoxifen（TAM）on endometrium in postoperative breast cancer patients treated with TAM.Methods Hysteroscopy and endometrial biopsies were performed in 69 patients having abnormal vaginal bleeding or abnormal thickness of endometrial by ultrasound in TAM group and in 60 patients with postmenopausal bleeding without tamoxifen as control group.TAM group was divided into premenopausal and menopausal group or three groups including T≤1 year,1 year〈T〈2 years and T≥2 years according to the time with tamoxifen.Results The frequency of endometrial polyps and hyperplasia was higher in TAM group,especially in menopausal group.All the atypical hyperplasia and endometrioid carcinoma cases occurred in menopausal group.The occurrence of endometrial disease increased along with the duration of taking TAM.Conclusion Risk of endometrial disease in postoperative breast cancer patients treated with TAM will be increased,especially in menopausal patients taking TAM more than 2 years.

关 键 词：三苯氧胺 子宫内膜 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]