Colin C
Service de Sénologie, Université de Liège, Belgique.
Rev Fr Gynecol Obstet. 1991 Jan;86(1):27-8.
If the administration of an estrogen alone increases the risk of breast and endometrium cancer, the addition of a progesterone derivative does not seem to change completely the risk of breast cancer whilst it clearly decreases that of the uterine one. One must be careful in making a large extrapolation of the data on the endometrium (progestogens inhibit the mitotic action of estrogens) to that on the mammary epithelium (inhibition of the estrogen activity at the canal level but synergy with estrogens at the lobe level). The high tissue concentrations of oestradiol at the mammary gland level after menopause could partly explain the small influence of exogenous estrogens administered alone and/or in combination with progestogens on the transformation of a gland already oversaturated with estrogens.
如果单独使用雌激素会增加患乳腺癌和子宫内膜癌的风险,那么添加孕激素衍生物似乎并不能完全改变患乳腺癌的风险,而它确实会明显降低患子宫癌的风险。在将关于子宫内膜的数据(孕激素抑制雌激素的有丝分裂作用)大量外推至乳腺上皮的数据(在导管水平抑制雌激素活性,但在小叶水平与雌激素协同作用)时必须谨慎。绝经后乳腺水平的高雌二醇组织浓度可能部分解释了单独和/或与孕激素联合使用的外源性雌激素对已经雌激素过度饱和的腺体转化影响较小的原因。