Marchesoni D, Driul L, Fabiani G, Di Loreto C, Cataldi P, Mozzanega B
Department of Surgical Sciences, University of Udine, Udine, Italy.
Int J Gynaecol Obstet. 2001 Dec;75(3):257-62. doi: 10.1016/s0020-7292(01)00476-3.
The aim of this study was to evaluate the effect of tamoxifen on the endometrium of post-menopausal women with breast cancer and to examine the relationship between ultrasonography, hysteroscopy and histopathologic changes.
Included in this longitudinal study were 303 post-menopausal women taking 20 mg daily of tamoxifen. Hysteroscopy was performed in 83 patients with an endometrial thickness of only >or=5 mm and 34 with vaginal bleeding also. Forty-five asymptomatic patients (control group) underwent hysteroscopies.
The most frequent outcome in patients with endometrial thickness of only >or=5 mm was an atrophic endometrium in an empty cavity (79.5%) whereas simple hyperplasia (35.3%) was found in women with vaginal bleeding. Carcinoma was diagnosed in seven cases (5.9%). In the control group, no endometrial cancer was found.
This study suggests that patients with a thickness >5 mm should be offered a whole hysteroscopic evaluation, whenever bleeding is reported.
本研究旨在评估他莫昔芬对绝经后乳腺癌患者子宫内膜的影响，并探讨超声检查、宫腔镜检查与组织病理学变化之间的关系。
本纵向研究纳入了303名每日服用20mg他莫昔芬的绝经后女性。对83名子宫内膜厚度仅≥5mm的患者以及34名有阴道出血症状的患者进行了宫腔镜检查。45名无症状患者（对照组）接受了宫腔镜检查。
子宫内膜厚度仅≥5mm的患者中最常见的结果是宫腔内萎缩性内膜（79.5%），而有阴道出血症状的女性中发现单纯性增生（35.3%）。7例（5.9%）诊断为癌症。对照组未发现子宫内膜癌。
本研究表明，无论何时报告有出血情况，对于子宫内膜厚度>5mm的患者均应进行全面的宫腔镜评估。
