Gambrell R D, Bagnell C A, Greenblatt R B
Am J Obstet Gynecol. 1983 Jul 15;146(6):696-707. doi: 10.1016/0002-9378(83)91014-1.
Our present knowledge of the role of sex steroids in the development as well as the prevention of endometrial cancer is reviewed. Factors which increase the exposure of the uterus to unopposed estrogens, either exogenous or endogenous, are associated with increased risk of endometrial adenocarcinoma. However, there is increasing evidence that progestogens can reverse endometrial hyperplasia and protect against the development of endometrial cancer. The mechanisms to explain the antiestrogenic effects of progestogens include changes in enzyme activity and steroid receptors in endometrial tissue. Postmenopausal women treated with combined estrogen and progestogen have the lowest incidence of endometrial carcinoma. Oral contraceptives containing both estrogen and progestogen in each tablet are protective against adenocarcinoma of the endometrium, while the sequential oral contraceptive pills afforded less protection. The risks and benefits of these hormone therapies are discussed in relation to the etiology and prevention of endometrial cancer.
本文综述了目前关于性类固醇在子宫内膜癌发生及预防中作用的认识。增加子宫暴露于无对抗雌激素（外源性或内源性）的因素与子宫内膜腺癌风险增加相关。然而，越来越多的证据表明孕激素可逆转子宫内膜增生并预防子宫内膜癌的发生。解释孕激素抗雌激素作用的机制包括子宫内膜组织中酶活性和类固醇受体的变化。接受雌激素和孕激素联合治疗的绝经后女性子宫内膜癌发病率最低。每片均含有雌激素和孕激素的口服避孕药可预防子宫内膜腺癌，而序贯口服避孕药的保护作用较小。本文还讨论了这些激素疗法在子宫内膜癌病因学和预防方面的风险与益处。
