乳腺癌术后内分泌治疗的子宫内膜癌变风险评估  

Risk assessment of endometrial cancer in postoperative endocrine therapy for breast cancer

作　　者：焦海宁[1] 勾泓荃 沈育红[1] Jiao Haining;Gou Hongquan;Shen Yuhong(Department of Obstetrics and Gynecology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Laboratory Medicine,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院妇产科,上海200025 [2]上海交通大学医学院检验系,上海200025

出　　处：《中国医师杂志》2025年第2期261-264,270,共5页Journal of Chinese Physician

摘　　要：目的评估乳腺癌术后应用内分泌治疗的患者发生子宫内膜癌的风险。方法回顾性分析2012年8月-2023年8月在上海交通大学医学院附属瑞金医院妇科就诊的117例乳腺癌患者的病历资料,乳腺癌根治术后均应用内分泌治疗药物,根据是否发生子宫内膜癌变分为癌变组和非癌变组。比较两组患者年龄、绝经年限、内分泌治疗时间、宫腔占位与否、子宫内膜厚度的差异,并利用多因素logistic回归模型评估乳腺癌患者术后应用内分泌治疗发生子宫内膜癌的风险。结果癌变与非癌变组间的年龄、绝经年限、内分泌治疗时间、宫腔占位比例比较差异均无统计学意义(均P>0.05);癌变组患者子宫内膜厚度明显大于非癌变组(P<0.001)。多因素logistic回归分析模型显示子宫内膜厚度是患者发生子宫内膜癌变的危险因素(P<0.05)。子宫内膜癌变风险分数对乳腺癌术后内分泌治疗患者的子宫内膜癌变风险预测灵敏度为83.3%,特异度为98.2%,阳性预测值71.4%,阴性预测值99.1%,预测效能较好。结论乳腺癌术后应用内分泌治疗发生子宫内膜癌变的患者子宫内膜厚度明显增加,可通过利用乳腺癌术后内分泌治疗患者的子宫内膜癌变风险分数预测患者发生子宫内膜癌变的可能。ObjectiveTo evaluate the risk of endometrial cancer in patients treated with endocrine therapy after breast cancer surgery.MethodsMedical records of 117 patients with breast cancer treated in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from August 2012 to August 2023 were retrospectively analyzed.All patients were treated with endocrine therapy drugs after radical surgery for breast cancer.They were divided into cancer group and non-cancer group according to whether endometrial cancer occurred.The differences in age,menopause years,duration of endocrine therapy,uterine cavity occupation,and endometrial thickness between the two groups were compared.Multivariate logistic regression model was used to evaluate the risk of endometrial cancer in breast cancer patients undergoing postoperative endocrine therapy.ResultsThere were no significant differences in age,menopause years,endocrine treatment time,uterine cavity occupation ratio between cancer and non-cancer groups(all P>0.05).Endometrial thickness in the cancer group was significantly higher than that in the non-cancer group(P<0.001).Multiple logistic regression analysis model showed that endometrial thickness was a risk factor for endometrial cancer(P<0.05).The sensitivity,specificity,positive predictive value(71.4%)and negative predictive value(99.1%)were 83.3%,98.2%,71.4%,and 99.1%respectively,for predicting the risk of endometrial cancer in patients with postoperative endocrine therapy.ConclusionsThe endometrial thickness of patients with endometrial cancer after breast cancer surgery using endocrine therapy is significantly increased,and the risk fraction of endometrial cancer in patients with endocrine therapy after breast cancer surgery can be used to predict the likelihood of endometrial cancer.

关 键 词：乳腺肿瘤 内分泌治疗 子宫内膜 

分 类 号：R73[医药卫生—肿瘤]