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乳腺癌病史女性的骨密度与子宫内膜厚度随时间的相关性。

Correlation between bone mineral density and endometrial thickness over time in women with breast cancer history.

机构信息

Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea.

Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea.

出版信息

Sci Prog. 2021 Jan-Mar;104(1):368504211000515. doi: 10.1177/00368504211000515.

Abstract

As the efficacy of chemotherapy and adjuvant endocrine therapy for breast cancer increase, the quality-of-life to cancer survivors could be more important issue in strategies of breast cancer treatment. Bone health has become more compelling in care of breast cancer survivor than ever before. This retrospective study was aimed to evaluate factors relating to the change in BMD and to ascertain the correlation between changes in BMD and EMT of women with breast cancer in follow-up. Records of 164 women who underwent surgery for breast cancer were reviewed in this study. The basal characteristics included parity, menopausal state, medication with vitamin D, bisphosphonate, selective estrogen modulator (SERM), aromatase inhibitor (AI), gonadotrophin releasing hormone agonist (GnRHa), chemotherapy, radiotherapy, cancer type including positivity of estrogen receptor, progesterone receptor and HER2, combined the other gynecologic disease or the other origin cancer. At initial and follow-up visit, all subjective were checked with BMD, endometrial thickness (EMT). The mean age was 52.1 ± 8.5 years old and overall interval between initial and follow-up visits were 17.6 ± 7.5 month in this study. The BMDs of L1-4 (1.040 ± 0.166 g/cm vs 1.070 ± 0.181 g/cm,  < 0.001), femur neck (0.850 ± 0.121 g/cm vs 0.870 ± 0.136 g/cm,  < 0.001), and femur total (0.902 ± 0.132 g/cm vs 0.915 ± 0.138 g/cm,  < 0.001) at follow-up visit were significantly lower than those at initial visit. The change in BMDs of L1-4 (BMD,  = 0.353,  < 0.001, and  = 0.228,  = 0.003), femur neck (BMD,  = 0.198,  = 0.011, and  = 0.282,  < 0.001), femur total (BMD,  = 0.294,  < 0.001, and  = 0.327,  < 0.001) had positive correlation with age and the change in EMT (EMT). After age correction, EMT had positive correlation with BMD ( = 0.245,  = 0.002) and BMD ( = 0.273,  < 0.001). BMD and BMD differed according to menopausal state ( < 0.001 and  = 0.035), bisphosphonate ( < 0.001 and  < 0.001), and GnRHa ( < 0.001 and  < 0.001). In follow-up of women with history of breast cancer, EMT could be an alternative screening marker for BMD decrease.

摘要

随着乳腺癌化疗和辅助内分泌治疗效果的提高,癌症幸存者的生活质量可能成为乳腺癌治疗策略中更为重要的问题。骨健康在乳腺癌幸存者的护理中变得比以往任何时候都更为重要。本回顾性研究旨在评估与骨密度变化相关的因素,并确定乳腺癌随访女性骨密度变化与 EMT 之间的相关性。本研究回顾了 164 名接受乳腺癌手术的女性的记录。基础特征包括产次、绝经状态、维生素 D、双磷酸盐、选择性雌激素受体调节剂 (SERM)、芳香化酶抑制剂 (AI)、促性腺激素释放激素激动剂 (GnRHa)、化疗、放疗、癌症类型包括雌激素受体、孕激素受体和 HER2 的阳性,合并其他妇科疾病或其他来源的癌症。在初始和随访时,均通过骨密度、子宫内膜厚度 (EMT) 对所有主观因素进行检查。本研究中,平均年龄为 52.1±8.5 岁,初始和随访的总间隔时间为 17.6±7.5 个月。在随访时,L1-4 处的骨密度 (1.040±0.166g/cm 比 1.070±0.181g/cm, < 0.001)、股骨颈 (0.850±0.121g/cm 比 0.870±0.136g/cm, < 0.001) 和股骨总 (0.902±0.132g/cm 比 0.915±0.138g/cm, < 0.001) 的骨密度明显低于初始检查时的骨密度。L1-4 处的骨密度变化 (BMD, = 0.353, < 0.001 和 = 0.228, = 0.003)、股骨颈处的骨密度变化 (BMD, = 0.198, = 0.011 和 = 0.282, < 0.001)、股骨总处的骨密度变化 (BMD, = 0.294, < 0.001 和 = 0.327, < 0.001) 与年龄和 EMT 变化呈正相关。在年龄校正后,EMT 与 BMD 呈正相关 ( = 0.245, = 0.002) 和 BMD ( = 0.273, < 0.001)。绝经状态 ( < 0.001 和 = 0.035)、双磷酸盐 ( < 0.001 和 < 0.001) 和 GnRHa ( < 0.001 和 < 0.001) 导致 BMD 和 BMD 出现差异。在有乳腺癌病史的女性随访中,EMT 可能是 BMD 下降的替代筛查标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a0e/10358553/bf9298c3c1bc/10.1177_00368504211000515-fig1.jpg

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