Jordan V C, Fritz N F, Tormey D C
Cancer Res. 1987 Aug 15;47(16):4517-9.
Plasma levels of luteinizing hormone, sex hormone binding globulin, and antithrombin III were measured in pre- and postmenopausal breast cancer patients receiving adjuvant combination chemotherapy or combination chemotherapy and long-term tamoxifen therapy. The aim was to determine the estrogen-like effects of tamoxifen. The premenopausal patients had received tamoxifen for between 434 and 2592 days and postmenopausal patients between 91 and 1560 days. Tamoxifen caused a consistent rise in sex hormone binding globulin in premenopausal (P less than 0.03) and postmenopausal (P less than 0.01) patients compared to chemotherapy controls. Luteinizing hormone levels were only significantly lowered (P less than 0.008) in premenopausal patients compared to chemotherapy controls. Antithrombin III levels were significantly depressed (P less than 0.001) in postmenopausal patients compared with chemotherapy controls. However, none of the patients had a value that was depressed by more than 30% of the laboratory control (the level of clinical significance). The mean for the group was 90% +/- 4 (mean +/- SD, N = 11). The estrogen-like rise in sex hormone binding globulin produced by adjuvant tamoxifen therapy could be advantageous for maintaining the antiestrogenic action of the drug. A decrease in antithrombin III occurred but was not within a range of clinical concern. We recommend, however, that patients with a history of thromboembolic disorders should be monitored carefully if placed on tamoxifen therapy.
对接受辅助联合化疗或联合化疗及长期他莫昔芬治疗的绝经前和绝经后乳腺癌患者，测定其血浆促黄体生成素、性激素结合球蛋白和抗凝血酶III水平。目的是确定他莫昔芬的雌激素样作用。绝经前患者接受他莫昔芬治疗的时间为434至2592天，绝经后患者为91至1560天。与化疗对照组相比，他莫昔芬使绝经前（P<0.03）和绝经后（P<0.01）患者的性激素结合球蛋白持续升高。与化疗对照组相比，仅绝经前患者的促黄体生成素水平显著降低（P<0.008）。与化疗对照组相比，绝经后患者的抗凝血酶III水平显著降低（P<0.001）。然而，没有患者的值降低超过实验室对照值的30%（临床意义水平）。该组的平均值为90%±4（平均值±标准差，N = 11）。辅助性他莫昔芬治疗产生的性激素结合球蛋白的雌激素样升高可能有利于维持该药物的抗雌激素作用。抗凝血酶III水平出现下降，但未达到临床关注范围。然而，我们建议，有血栓栓塞性疾病病史的患者如果接受他莫昔芬治疗，应进行仔细监测。
