尽管使用左炔诺孕酮宫内节育系统进行宫内孕激素治疗，非典型子宫内膜增生仍进展为腺癌。
Progression of atypical endometrial hyperplasia to adenocarcinoma despite intrauterine progesterone treatment with the levonorgestrel-releasing intrauterine system.
作者信息
Kresowik J, Ryan G L, Van Voorhis B J
机构信息
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa 52242-1080, USA.
出版信息
Obstet Gynecol. 2008 Feb;111(2 Pt 2):547-9. doi: 10.1097/01.AOG.0000300716.84819.c6.
BACKGROUND
Intrauterine progesterone therapy has been proposed as a potential uterine-sparing treatment for atypical endometrial hyperplasia and adenocarcinoma.
CASE
We present a case of an infertility patient with atypical endometrial hyperplasia who was treated with the levonorgestrel-releasing intrauterine system for 6 months. At follow-up, she was noted to have an increasing endometrial thickness on ultrasonography, and biopsy revealed progression of her lesion to adenocarcinoma.
CONCLUSION
Although there is a need for uterine-sparing treatment for atypical endometrial hyperplasia and early adenocarcinoma, especially in the setting of desired fertility, caution should be exercised. We do not recommend using the levonorgestrel-releasing intrauterine system as a treatment for atypical hyperplasia or adenocarcinoma until further studies demonstrate the efficacy of this treatment.
背景
子宫内孕激素治疗已被提议作为非典型子宫内膜增生和腺癌的一种潜在保留子宫的治疗方法。
病例
我们报告一例患有非典型子宫内膜增生的不孕患者，其接受左炔诺孕酮宫内节育系统治疗6个月。随访时，超声检查发现她的子宫内膜厚度增加，活检显示病变进展为腺癌。
结论
尽管对于非典型子宫内膜增生和早期腺癌需要保留子宫的治疗，尤其是在有生育需求的情况下，但应谨慎行事。在进一步研究证明这种治疗的有效性之前，我们不建议使用左炔诺孕酮宫内节育系统治疗非典型增生或腺癌。
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