促性腺激素释放激素激动剂联合左炔诺孕酮宫内节育系统在宫腔镜术后早期高分化子宫内膜癌患者中的应用效果  

Application effect of gonadotropin-releasing hormone agonist combined with levonorgestrel intrauterine system in patients with early and well differentiated endometrial cancer after hysteroscopic surgery

作　　者：张吉 施海瑛 刘廷辉 ZHANG Ji;SHI Haiying;LIU Tinghui(Department of Reproductive Medicine,Ganzhou People’s Hospital,Ganzhou 341000,Jiangxi,China)

机构地区：[1]赣州市人民医院生殖医学科,江西赣州3410000

出　　处：《癌症进展》2024年第19期2155-2158,2174,共5页Oncology Progress

摘　　要：目的探讨促性腺激素释放激素激动剂(GnRHa)联合左炔诺孕酮宫内节育系统在宫腔镜术后早期高分化子宫内膜癌患者中的应用效果。方法依据宫腔镜术后治疗方法的不同将50例宫腔镜术后早期高分化子宫内膜癌患者分为对照组和观察组,每组25例,对照组患者宫腔镜术后给予GnRHa治疗,观察组患者宫腔镜术后给予GnRHa联合左炔诺孕酮宫内节育系统治疗。比较两组患者的临床疗效、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、肿瘤标志物[糖类抗原125(CA125)、人附睾蛋白4(HE4)]、性激素[促卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇]、不良反应发生情况及妊娠情况。结果观察组患者的总缓解率、妊娠成功率均高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者IL-6、CRP、TNF-α、CA125、HE4、FSH、LH、雌二醇水平均低于本组治疗前,观察组患者IL-6、CRP、TNF-α、CA125、HE4、FSH、LH、雌二醇水平均低于对照组,差异均有统计学意义(P<0.05)。观察组患者的不良反应总发生率、不良妊娠结局比较,差异均无统计学意义(P>0.05)。结论GnRHa联合左炔诺孕酮宫内节育系统治疗宫腔镜术后早期高分化子宫内膜癌患者的效果显著,可降低其炎症因子、肿瘤标志物、性激素水平,提高妊娠成功率,且不良反应及不良妊娠结局发生率均较低。Objective To investigate the application effect of gonadotropin-releasing hormone agonist(GnRHa)combined with levonorgestrel intrauterine system in patients with early and well-differentiated endometrial cancer after hysteroscopic surgery.Method According to different treatment methods after hysteroscopic surgery,50 patients with early and well-differentiated endometrial cancer after hysteroscopic surgery were divided into control group and observation group,with 25 cases in each group.The control group received GnRHa treatment after hysteroscopic surgery,while the observation group received GnRHa combined with levonorgestrel intrauterine system after hysteroscopic surgery.The clinical efficacy,inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],tumor markers[carbohydrate antigen 125(CA125),human epididymal protein 4(HE4)],sex hormones[follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol],incidence of adverse reactions,and pregnancy status were com-pared between the two groups.Result The overall response rate and pregnancy success rate of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of IL-6,CRP,TNF-α,CA125,HE4,FSH,LH,estradiol in both groups were lower than those before treat-ment,the levels of IL-6,CRP,TNF-α,CA125,HE4,FSH,LH,estradiol in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the total incidence of adverse reactions and adverse pregnancy outcomes between the two groups(P>0.05).Con-clusion GnRHa combined with levonorgestrel intrauterine system has a significant effect in the treatment of early and well-differentiated endometrial cancer patients after hysteroscopic surgery.It can reduce the levels of inflammatory factors,tumor markers and sex hormone levels,increase pregnancy success rate,and have a low incidence of

关 键 词：子宫内膜癌 促性腺激素释放激素激动剂 左炔诺孕酮宫内节育系统 宫腔镜病灶切除术 妊娠结局 

分 类 号：R737.33[医药卫生—肿瘤]