Department of Obstetrics and Gynecology, State Medical University n.a. V.F. Voyno-Yasenetsky, Krasnoyarsk, Russia.
Gynecol Endocrinol. 2012 Jul;28(7):559-61. doi: 10.3109/09513590.2011.649813. Epub 2012 Feb 2.
In this article, we present the results of organ-preserving treatment applied in 24 patients of reproductive age with atypical endometrial hyperplasia or early-stage endometrial cancer. All of them would like to preserve their reproductive potential. Thirteen women with atypical endometrial hyperplasia were treated with the combination of six intramuscular injections of 3.75 mg gonadotropin-releasing hormone agonist (GnRHa)--leuproreline acetate depot every 4 weeks. After the third injection of 3.75 mg of leuproreline acetate, the levonorgestrel intrauterine hormonal system containing 52 mg levonorgestrel (Mirena®, Bayer, Germany) was inserted for at least 6 months. In 11 women with stage IA well-differentiated endometrial adenocarcinoma, hormonal therapy included nine intramuscular injections of 3.75 mg of GnRHa every 4 weeks. After the third injection of 3.75 mg of GnRHa, we also inserted a GnRH-IUS (Mirena®) for at least 12 months. This type of therapy was effective for all these patients and may be offered to be used as an alternative to surgery in women with atypical endometrial hyperplasia or early stage 1A well-differentiated endometrial cancer in women of reproductive age. Three women with endometrial cancer became pregnant and two of them delivered at term and one has an ongoing pregnancy.
在这篇文章中，我们介绍了在 24 名有生育需求的、患有非典型子宫内膜增生或早期子宫内膜癌的患者中应用保留器官治疗的结果。所有这些患者都希望保留其生育能力。13 名患有非典型子宫内膜增生的患者接受了 6 次 3.75mg 促性腺激素释放激素激动剂（GnRHa）-醋酸亮丙瑞林肌内注射（每 4 周 1 次）的联合治疗。在第三次注射 3.75mg 醋酸亮丙瑞林后，至少 6 个月内插入含 52mg 左炔诺孕酮的左炔诺孕酮宫内节育系统（Mirena®，拜耳，德国）。在 11 名患有 IA 期高分化子宫内膜腺癌的患者中，激素治疗包括 9 次 3.75mg GnRHa 肌内注射（每 4 周 1 次）。在第三次注射 3.75mg GnRHa 后，我们还插入了 GnRH-IUS（Mirena®）至少 12 个月。这种治疗方法对所有这些患者都有效，并且可以作为患有非典型子宫内膜增生或有生育需求的 IA 期高分化子宫内膜癌患者的替代手术方法。3 名患有子宫内膜癌的患者怀孕，其中 2 名足月分娩，1 名持续妊娠。
