宫腔镜联合孕激素治疗年轻患者早期子宫内膜癌的疗效及预后分析

发布时间：2018-08-04 09:59

【摘要】：目的:探讨宫腔镜联合孕激素治疗年轻早期子宫内膜癌患者的疗效及预后。方法:回顾性分析四川大学华西第二医院2008年1月至2014年12月自愿接受宫腔镜联合孕激素治疗的年轻早期子宫内膜癌16例患者的临床资料,且随访资料完整。所有患者行宫腔镜下刮宫或宫腔镜下病灶切除+刮宫,其中7例联合口服醋酸甲羟孕酮(250 mg/d,MPA组),9例联合醋酸甲地孕酮(160 mg/d,MA组)治疗。比较两组患者缓解、复发及生育等情况。结果:随访中位时间为54个月(17~90个月),其中12例(75.0%)完全缓解,3例(18.8%)部分缓解,1例(6.2%)无反应,MPA组和MA组的完全缓解率分别为71.4%(5/7)和77.8%(7/9),差异无统计学意义(P0.05)。16例患者中有3例在完全缓解后复发(MPA组1例,MA组2例),复发平均时间为42个月。16例患者中有8例(50.0%)完成了妊娠(其中1例2次妊娠),有6次(66.6%)妊娠顺利生产,3次(33.3%)流产。结论:宫腔镜联合孕激素治疗对于年轻早期子宫内膜癌患者保守治疗是有效的,其中MPA和MA的治疗效果无明显差异,但均存在着一定的复发风险,所以应对其进行严格的筛选和严密的随访。
[Abstract]:Objective: to evaluate the efficacy and prognosis of hysteroscopy combined with progesterone in the treatment of early endometrial carcinoma. Methods: the clinical data of 16 young patients with early endometrial carcinoma who were voluntarily treated with hysteroscopy and progesterone from January 2008 to December 2014 in Huaxi second Hospital of Sichuan University were analyzed retrospectively and the follow-up data were complete. All patients were treated with hysteroscopic curettage or hysteroscopic curettage. Among them, 7 cases were treated with oral medroxyprogesterone acetate (250 mg / d MPA group) and 9 cases with megestrol acetate (160 mg / d PMA group). The remission, recurrence and fertility were compared between the two groups. Results: the median follow-up time was 54 months (1790 months), of which 12 cases (75.0%) had complete remission, 3 cases (18.8%) had partial remission and 1 case (6.2%) had partial remission. The complete remission rates of MPA group and MA group were 71.4% (5 / 7) and 77.8% (7 / 9), respectively. The difference was not statistically significant (P0.05) .16 cases. 3 cases recurred after complete remission (1 case in MPA group, 2 cases in MA group). The average time of recurrence was 42 months. Of 16 cases, 8 cases (50.0%) completed pregnancy (1 case 2 pregnancies), 6 cases (66.6%) gave birth successfully 3 times (33.3%). Conclusion: hysteroscopy combined with progesterone therapy is effective for conservative treatment of young early endometrial carcinoma patients. There is no significant difference between MPA and MA, but there is a certain risk of recurrence. Therefore, it should be strictly screened and closely followed up.
【作者单位】：四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室;
【分类号】：R737.33

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