Korkmazer Engin, Solak Neşe, Tokgöz Vehbi Yavuz
Giresun University Faculty of Medicine, Department of Gynecology and Obstetrics, Giresun, Turkey.
Giresun Maternity and Chilt Health Hospital, Clinic of Gynecology and Obstetrics, Giresun, Turkey.
Turk J Obstet Gynecol. 2014 Dec;11(4):215-218. doi: 10.4274/tjod.82621. Epub 2014 Dec 15.
Aim of this study was to evaluate role of hysteroscopy in thickened endometrium (>5 mm) associated with tamoxifen therapy.
We performed dilatation and curettage (D&C) and hysteroscopic biopsy to patients for evaluation of thickened endometrium in tamoxifen therapy. One hundred and nine asymptomatic patients with estrogen receptor positive breast cancer treated with tamoxifen 20 mg daily. We performed hysteroscopic biopsy or D&C to patients who have thickened endometrium at transvaginal sonography. We correlate pathology report results of D&C and hysteroscopic biopsy.
Fifty-nine of 103 patients have thickened endometrium.Thirty-five of 59 patients diagnosed with D&C (19 inactive endometrium, 15 endometrial polyp, 1 endometrial hyperplasia). D&C couldn't get material 24 of these patients. Hysteroscopic biopsy diagnosed endometrial polyp 11 (45.8%) of these patients.
We can state that D&C does not seem accurate enough for detection of intrauterin pathologies in thickened endometrium associated with tamoxifen therapy. We therefore believe it is reasonable to perform hysteroscopic biopsy in asymptomatic tamoxifen treated patients who have thickened endometrium.
本研究的目的是评估宫腔镜检查在他莫昔芬治疗相关的子宫内膜增厚（>5mm）中的作用。
我们对接受他莫昔芬治疗的子宫内膜增厚患者进行了刮宫术（D&C）和宫腔镜活检。109例无症状的雌激素受体阳性乳腺癌患者，每日服用20mg他莫昔芬。对经阴道超声检查显示子宫内膜增厚的患者进行了宫腔镜活检或刮宫术。我们将刮宫术和宫腔镜活检的病理报告结果进行了关联。
103例患者中有59例子宫内膜增厚。59例患者中35例经刮宫术诊断（19例为静止期子宫内膜，15例为子宫内膜息肉，1例为子宫内膜增生）。其中24例患者刮宫术未能获取组织。宫腔镜活检诊断这些患者中有11例（45.8%）为子宫内膜息肉。
我们可以说，刮宫术对于检测他莫昔芬治疗相关的子宫内膜增厚中的子宫内病变似乎不够准确。因此，我们认为对于无症状的接受他莫昔芬治疗且子宫内膜增厚的患者进行宫腔镜活检是合理的。
