Klopper A
Acta Endocrinol Suppl (Copenh). 1980;233:29-35.
Although there is no doubt that increasing numbers of women are presenting with carcinoma of the endometrium, this could be due only to the fact that many more women live to an age when they are liable to get this cancer. Even when age specific incidence rates are considered, the apparent increase could be due to risk factors other than oestrogens. Recent developments in hormone replacement therapy have placed increasing emphasis on the natural oestrogens, oestradiol and oestrone, but they present problems of their own. Nor has the induction of periodic bleeding by cyclical administration of oestrogens, with or without a progestogen, proved an unqualified success. A special case might yet be made for the weaker physiological oestrogen, oestriol.
虽然毫无疑问,患子宫内膜癌的女性人数在不断增加,但这可能仅仅是因为有更多女性活到了易患这种癌症的年龄。即使考虑年龄特异性发病率,明显的增加也可能是由雌激素以外的风险因素导致的。激素替代疗法的最新进展越来越强调天然雌激素、雌二醇和雌酮,但它们自身也存在问题。通过周期性服用雌激素(无论有无孕激素)诱导周期性出血也并未取得完全成功。对于较弱的生理性雌激素雌三醇,可能仍需特殊考虑。