Kato J
Gan No Rinsho. 1985 Jul;31(9 Suppl):1182-8.
Progestin therapy is indicated for advanced or metastatic endometrial cancer as well as a adjuvant therapy for primary cancer. There are several predictors of tumor responsiveness to the hormone. Sex steroid receptor(R) is a biochemical marker. Receptor analysis was done in 73 cases of primary endometrial cancer. The concentrations of estrogen (E), progestin (P) and androgen (A) were found to correlate with the degree of tumor differentiation; well-differentiated tumor contains significantly greater receptors than moderately-and poorly-differentiated tumors. Both ER and PR were positive in about 80% of the well-differentiated tumor, but negative in 50% of the poorly-differentiated tumors. Analysis of 13 cases of death shows some correlation of the PR concentrations with the survival time. Receptor dynamics in tumor of the patients enables us to predict possible site(s) of impaired responsiveness to progestin. Furthermore, in addition to progestin and estrogen test, tamoxifen challenge test is useful as in vivo sensitivity test. Moreover, receptor manipulation by tamoxifen may be employed to enhance hormonal sensitivity of the tumor, particularly the low receptor one.
孕激素疗法适用于晚期或转移性子宫内膜癌以及原发性癌症的辅助治疗。有几种肿瘤对该激素反应性的预测指标。性甾体受体（R）是一种生化标志物。对73例原发性子宫内膜癌进行了受体分析。发现雌激素（E）、孕激素（P）和雄激素（A）的浓度与肿瘤分化程度相关；高分化肿瘤含有的受体明显多于中分化和低分化肿瘤。在约80%的高分化肿瘤中雌激素受体（ER）和孕激素受体（PR）均为阳性，但在50%的低分化肿瘤中为阴性。对13例死亡病例的分析显示PR浓度与生存时间存在一定相关性。患者肿瘤中的受体动态变化使我们能够预测对孕激素反应性受损的可能部位。此外，除了孕激素和雌激素检测外，他莫昔芬激发试验作为一种体内敏感性检测很有用。而且，可采用他莫昔芬进行受体调控以增强肿瘤的激素敏感性，尤其是低受体肿瘤。
