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术后激素替代疗法对卵巢恶性肿瘤患者生活质量及预后的影响

Impact of post-operative hormone replacement therapy on life quality and prognosis in patients with ovarian malignancy.

作者信息

Li Li, Pan Zhongmian, Gao Kun, Zhang Wei, Luo Yuan, Yao Zhongqiang, Liang Xinqiang, Tang Bujian, Li Qingdi Quentin

机构信息

Department of Gynecologic Oncology, Cancer Hospital, Guangxi Medical University, Nanning, Guangxi 530021, P.R. China.

出版信息

Oncol Lett. 2012 Jan;3(1):244-249. doi: 10.3892/ol.2011.461. Epub 2011 Oct 25.

Abstract

The present study aimed to assess the impact of post-surgical hormone replacement therapy (HRT) on life quality and prognosis in women with ovarian malignancy. HRT (Premarin, Nilestriol and medroxyprogesterone) was administered following surgery in 31 patients with ovarian cancer. A total of 44 ovarian cancer patients of similar age, clinical stage and pathological features did not receive HRT following surgery. The expression of estrogen receptor (ER)-α, ERβ and progesterone receptor (PR) in cancer tissues was detected by immunohistochemical staining. Serum levels of calcitonin (CT) and transforming growth factor (TGF)-α were determined by radioimmunoassay and enzyme-linked immunosorbent assay, respectively. Data were analyzed using Kaplan-Meier survival curves, a log-rank test and a Cox scale risk model. Quality of life was assessed in the patient groups and in healthy post-menopausal women (control) based on a questionnaire developed by the European Organization of Research and Treatment of Cancer (EORTC-C30), as well as our own specific questionnaire. A log-rank test revealed no difference in survival between the patients with and without HRT (p>0.05), and a Cox model showed that HRT was not an independent prognostic factor. The accumulated survival rate did not differ significantly based on the expression of ERα, ERβ or PR in patients with or without HRT (p>0.05). The serum TGFα levels prior to and following surgery were not significantly different in either of the two patient groups (p>0.05). Serum CT levels were higher in patients without HRT at 1.5 years following surgery (p<0.05), but no significant difference was found in the serum CT levels of patients receiving HRT. The HRT and non-HRT groups differed significantly with regard to the body and emotional functional sub-scales of the EORTC-C30 (p<0.05) and the sex quality and autonomic nerve maladjustment categories of our specific questionnaire (p<0.05). Findings of this study showed that HRT administered following surgery exhibited no apparent negative effect on prognosis in patients with ovarian cancer, regardless of ERα, ERβ or PR expression in cancer tissues, and had no effect on serum transforming growth factor (TGF)-α levels. Post-surgical HRT aided in the stabilization of serum CT levels and improved the quality of life in these patients.

摘要

本研究旨在评估术后激素替代疗法(HRT)对卵巢恶性肿瘤女性生活质量和预后的影响。对31例卵巢癌患者术后给予HRT(结合雌激素、尼尔雌醇和甲羟孕酮)。共有44例年龄、临床分期和病理特征相似的卵巢癌患者术后未接受HRT。通过免疫组织化学染色检测癌组织中雌激素受体(ER)-α、ERβ和孕激素受体(PR)的表达。分别采用放射免疫分析和酶联免疫吸附测定法测定血清降钙素(CT)和转化生长因子(TGF)-α水平。使用Kaplan-Meier生存曲线、对数秩检验和Cox比例风险模型分析数据。基于欧洲癌症研究与治疗组织(EORTC-C30)编制的问卷以及我们自己的特定问卷,对患者组和健康绝经后女性(对照组)的生活质量进行评估。对数秩检验显示接受HRT和未接受HRT的患者生存率无差异(p>0.05),Cox模型表明HRT不是独立的预后因素。无论是否接受HRT,患者中ERα、ERβ或PR的表达对累积生存率均无显著差异(p>0.05)。两组患者术前和术后的血清TGFα水平均无显著差异(p>0.05)。未接受HRT的患者术后1.5年时血清CT水平较高(p<0.05),但接受HRT的患者血清CT水平无显著差异。在EORTC-C30的身体和情感功能子量表(p<0.05)以及我们特定问卷的性质量和自主神经失调类别方面,HRT组和非HRT组存在显著差异(p<0.05)。本研究结果表明,术后给予HRT对卵巢癌患者的预后无明显负面影响,无论癌组织中ERα、ERβ或PR的表达如何,且对血清转化生长因子(TGF)-α水平无影响。术后HRT有助于稳定血清CT水平并改善这些患者的生活质量。

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