Lahti E, Blanco G, Kauppila A, Apaja-Sarkkinen M, Taskinen P J, Laatikainen T
Department of Obstetrics and Gynecology, University of Oulu, Finland.
Obstet Gynecol. 1993 May;81(5 ( Pt 1)):660-4.
To assess the estrogenic effect of tamoxifen and associated pathologic changes of the endometrium in postmenopausal breast cancer patients.
The endometrium of 103 gynecologically asymptomatic postmenopausal breast cancer patients was examined. Fifty-one had been treated with tamoxifen and 52 had not received any hormonal treatment. The two groups were similar in age, parity, age at menopause, and body mass index.
Compared with the control subjects, the tamoxifen patients had a thicker endometrium (mean +/- standard deviation 10.4 +/- 5.0 versus 4.2 +/- 2.7 mm; P = .0001) and larger uterine volume (45 +/- 27 versus 25 +/- 11 cm3; P = .001), as determined by transvaginal sonography. Hysteroscopy showed an atrophic endometrium in 28% of the patients in the tamoxifen group, as compared with 87% of the control patients (P = .0001). Endometrial polyps were more frequent in the tamoxifen group (36 versus 10%; P = .004), which included one patient with atypical hyperplasia, one with adenomatous hyperplasia, and one with endometrial adenocarcinoma; two controls had endometrial adenocarcinoma.
The results provide evidence for an estrogenic effect of long-term tamoxifen treatment on the postmenopausal uterus and show it to be associated with an increased occurrence of polyps.
评估他莫昔芬对绝经后乳腺癌患者的雌激素作用及相关子宫内膜病理变化。
检查103例妇科无症状的绝经后乳腺癌患者的子宫内膜。51例接受了他莫昔芬治疗，52例未接受任何激素治疗。两组在年龄、产次、绝经年龄和体重指数方面相似。
经阴道超声检查发现，与对照组相比，他莫昔芬治疗组患者的子宫内膜更厚（平均±标准差为10.4±5.0 vs 4.2±2.7 mm；P = .0001），子宫体积更大（45±27 vs 25±11 cm³；P = .001）。宫腔镜检查显示，他莫昔芬治疗组28%的患者子宫内膜萎缩，而对照组为87%（P = .0001）。他莫昔芬治疗组子宫内膜息肉更为常见（36% vs 10%；P = .004），其中包括1例非典型增生患者、1例腺瘤样增生患者和1例子宫内膜腺癌患者；2例对照组患者患有子宫内膜腺癌。
结果为长期他莫昔芬治疗对绝经后子宫的雌激素作用提供了证据，并表明其与息肉发生率增加有关。
