Gambacciani M, Monteleone P, Sacco A, Genazzani A R
Department of Reproductive Medicine and Child Development, Division of Obstetrics and Gynecology, Via Roma 35, Pisa, Italy.
Best Pract Res Clin Endocrinol Metab. 2003 Mar;17(1):139-47. doi: 10.1016/s1521-690x(02)00086-6.
Sex-steroid-related tumours in women are represented by breast cancer and endometrial cancer, but a possible relationship may exist between sex steroids and both ovarian and colon cancer. Unopposed oestrogen therapy is known to increase the risk of endometrial cancer and is appropriate only for hysterectomized women. In women with an intact uterus, an appropriate combination of oestrogen and progestin does not appear to increase-and may even decrease-the risk of endometrial cancer. Current users of HRT seem to benefit from a reduced risk for colon cancer. As for epithelial ovarian cancer, the present data are very conflicting. The association between replacement hormones and this malignancy seems to be stronger for unopposed oestrogen than for oestrogen-progestin treatment. Data available at the moment do not allow discriminating for dose, routes of administration, bioavailability and tissue effects of different compounds so that it is inappropriate to consider all forms of HRT jointly. The future of HRT in post-menopausal women lies in the individualization of the therapy based upon personal risk factors and characteristics.
女性与性类固醇相关的肿瘤以乳腺癌和子宫内膜癌为代表，但性类固醇与卵巢癌和结肠癌之间可能存在关联。已知无对抗的雌激素疗法会增加子宫内膜癌的风险，仅适用于子宫切除的女性。对于子宫完整的女性，雌激素和孕激素的适当组合似乎不会增加——甚至可能降低——子宫内膜癌的风险。目前使用激素替代疗法（HRT）的人似乎受益于结肠癌风险的降低。至于上皮性卵巢癌，目前的数据非常矛盾。与雌激素 - 孕激素治疗相比，无对抗的雌激素与这种恶性肿瘤之间的关联似乎更强。目前可得的数据无法区分不同化合物的剂量、给药途径、生物利用度和组织效应，因此不宜将所有形式的HRT一并考虑。绝经后女性HRT的未来在于根据个人风险因素和特征进行个体化治疗。
