低剂量和高剂量醋酸甲羟孕酮对绝经后乳腺癌患者性类固醇和性激素结合球蛋白的影响。
The effects of low and high dose medroxyprogesterone acetate on sex steroids and sex hormone binding globulin in postmenopausal breast cancer patients.
作者信息
Dowsett M, Lal A, Smith I E, Jeffcoate S L
出版信息
Br J Cancer. 1987 Mar;55(3):311-3. doi: 10.1038/bjc.1987.61.
The possibility that medroxyprogesterone acetate (MPA) is clinically effective at least in part by its suppression of adrenal steroidogenesis and a resultant reduction of circulating oestrogen levels was investigated in 49 postmenopausal patients with advanced breast cancer. Thirty-one patients were treated with low dose MPA (100 mg three times daily) and 16 patients with high dose MPA (250 mg four times daily). Plasma levels of androstenedione, testosterone, oestrone and oestradiol were all significantly reduced during treatment, with the suppression being most marked for the 17 beta hydroxysteroids, testosterone and oestradiol. The fall in oestradiol levels was to about 50% of pretreatment levels, but a concomitant fall in SHBG levels to less than 25% of baseline probably resulted in the fall in free, biologically active oestradiol being only to about 70-80% of pretreatment. It is unlikely that this is a major determinant of the activity of MPA in breast cancer.
在49例绝经后晚期乳腺癌患者中，研究了醋酸甲羟孕酮（MPA）至少部分通过抑制肾上腺类固醇生成及由此导致循环雌激素水平降低而产生临床疗效的可能性。31例患者接受低剂量MPA治疗（每日3次，每次100mg），16例患者接受高剂量MPA治疗（每日4次，每次250mg）。治疗期间，血浆雄烯二酮、睾酮、雌酮和雌二醇水平均显著降低，其中17β-羟类固醇、睾酮和雌二醇的抑制最为明显。雌二醇水平降至治疗前水平的约50%，但同时性激素结合球蛋白（SHBG）水平降至基线的不到25%，这可能导致游离的、具有生物活性的雌二醇仅降至治疗前的约70 - 80%。这不太可能是MPA在乳腺癌中发挥作用的主要决定因素。
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