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[他莫昔芬在绝经前和绝经后子宫内膜癌患者治疗中的作用]

[The roles of tamoxifen in the treatment of pre- and post-menopausal endometrial carcinoma patients].

作者信息

Sun H, Zhang X

机构信息

Obstetric and Gynecologic Hospital of Shanghai Medical University.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 1996 Feb;31(2):83-5.

PMID:8758799
Abstract

OBJECTIVE

To investigate the role of tamoxifen in the treatment of pre- and post-menopausal patients with endometrial carcinoma, its mechanism and effects.

METHODS

Forty patients of endometrial cancer were divided into pre- and post-menopausal groups. Each group was treated with oral tamoxifen 20mg three times per day for 10 days. The changes of serum levels of sex hormones, levels of estrogen and progesterone receptor (ER, PR) in carcinoma tissue as well as histopathologic changes following tamoxifen treatments were observed and compared.

RESULTS

Histological changes showed that the cell nucleus to cell plasma ratio decreased, the nuclear mitoses reduced and the nuclear shape varied from stick to circular, indicating a tendency of cancer cells towards better differentiation. For pre-menopausal patients, follicle-stimulating hormone (FSH) increased, the concentration of ER either rose or went down while PR increased. For post-menopausal patients, FSH decreased, the concentrations of ER and PR were mainly on the increase.

CONCLUSION

Tamoxifen was effective in treating patients with endometrial cancer. For pre-menopausal patients, it acted as an antioestrogen. For post-menopausal patients, it acted as a weak oestrogen.

摘要

目的

探讨他莫昔芬在治疗绝经前后子宫内膜癌患者中的作用、机制及效果。

方法

将40例子宫内膜癌患者分为绝经前组和绝经后组。每组患者每天口服他莫昔芬20mg,每日3次,共10天。观察并比较他莫昔芬治疗后患者血清性激素水平、癌组织中雌激素和孕激素受体(ER、PR)水平的变化以及组织病理学变化。

结果

组织学变化显示,细胞核与细胞质的比例降低,核分裂减少,核形状从棒状变为圆形,表明癌细胞有向更好分化的趋势。对于绝经前患者,促卵泡生成素(FSH)升高,ER浓度要么升高要么降低,而PR升高。对于绝经后患者,FSH降低,ER和PR浓度主要呈上升趋势。

结论

他莫昔芬对子宫内膜癌患者有效。对于绝经前患者,它起抗雌激素作用。对于绝经后患者,它起弱雌激素作用。

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