他莫昔芬和雷洛昔芬（STAR）用于乳腺癌预防研究的 NSABP 参与者的妇科状况。
Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR).
机构信息
National Surgical Adjuvant Breast and Bowel Project, National Cancer Institute, Pittsburgh, PA, USA.
出版信息
Am J Obstet Gynecol. 2011 Dec;205(6):535.e1-5. doi: 10.1016/j.ajog.2011.06.067. Epub 2011 Jun 24.
OBJECTIVE
This study reports the gynecologic conditions in postmenopausal women (intact uterus on enrollment) in the National Surgical Adjuvant Breast and Bowel Project (NSABP) study of tamoxifen and raloxifene (STAR)/P-2 trial.
STUDY DESIGN
This study, with a median follow-up period of 81 months, evaluated the incidence rates/risks of gynecologic conditions among women who were treated with tamoxifen and raloxifene.
RESULTS
Compared with women who received tamoxifen therapy, women who received raloxifene therapy had a lower incidence of uterine cancer (relative risk, 0.55)/endometrial hyperplasia (relative risk, 0.19), leiomyomas (relative risk, 0.55), ovarian cysts (relative risk, 0.60), and endometrial polyps (relative risk, 0.30) and had fewer procedures performed. Women receiving tamoxifen therapy had more hot flashes (P < .0001), vaginal discharge (P < .0001), and vaginal bleeding (P < .0001).
CONCLUSION
Our results suggest that tamoxifen has more of an estrogenic effect on the gynecologic reproductive organs. These effects should be considered in counseling women on options for breast cancer prevention.
目的
本研究报告了绝经后妇女（入组时子宫完整）在国家外科辅助乳腺和肠道项目（NSABP）的他莫昔芬和雷洛昔芬（STAR）/P-2 试验中的妇科状况。
研究设计
本研究中位随访时间为 81 个月，评估了接受他莫昔芬和雷洛昔芬治疗的女性中妇科疾病的发生率/风险。
结果
与接受他莫昔芬治疗的女性相比，接受雷洛昔芬治疗的女性患子宫癌（相对风险，0.55）/子宫内膜增生（相对风险，0.19）、子宫肌瘤（相对风险，0.55）、卵巢囊肿（相对风险，0.60）和子宫内膜息肉（相对风险，0.30）的发病率较低，并且接受的手术较少。接受他莫昔芬治疗的女性出现更多热潮红（P <.0001）、阴道分泌物（P <.0001）和阴道出血（P <.0001）。
结论
我们的结果表明，他莫昔芬对妇科生殖器官具有更强的雌激素作用。在为女性提供乳腺癌预防方案咨询时，应考虑这些影响。
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