Dallenbach-Hellweg G, Hahn U, Schmidt D
Institut für Pathologie, A 2, 2, Mannheim.
Zentralbl Gynakol. 1996;118(6):365-9.
Women receiving tamoxifen as adjuvant therapy for breast cancer usually develop atrophy of the endometrium. Cystic polyps as well as endocervical and clear-cell metaplasias also frequently arise in the these atrophic endometria. The invasive endometrial carcinomas we have observed in these women have all been until now either mucinous, clear-cell or serous-papillary carcinomas, that is, different from the endometrioid type of adenocarcinomas that arise under estrogenic stimulation. Our histological studies support the assumption that tamoxifen has an antiestrogenic, gestagen-like action on the endometrium; they contradict the premise that tamoxifen therapy exerts an estrogen effect.
接受他莫昔芬作为乳腺癌辅助治疗的女性通常会出现子宫内膜萎缩。在这些萎缩的子宫内膜中,囊性息肉以及宫颈内膜化生和透明细胞化生也经常出现。到目前为止,我们在这些女性中观察到的侵袭性子宫内膜癌均为黏液性、透明细胞性或浆液性乳头状癌,即与在雌激素刺激下发生的子宫内膜样腺癌不同。我们的组织学研究支持这样的假设,即他莫昔芬对子宫内膜具有抗雌激素、孕激素样作用;它们与他莫昔芬治疗产生雌激素效应这一前提相矛盾。