Comerci J T, Fields A L, Runowicz C D, Goldberg G L
Department of Obstetrics and Gynecology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461, USA.
Gynecol Oncol. 1997 Mar;64(3):425-30. doi: 10.1006/gyno.1996.4559.
Hormone replacement therapy (HRT) provides relief of menopausal symptoms, reverses atrophic urogenital changes, prevents osteoporosis, and produces favorable lipoprotein effects. Continuous combined HRT using 2.5 mg of medroxyprogesterone was designed to increase patient compliance by eliminating withdrawal bleeding while at the same time retaining the beneficial effects of HRT. There are limited long-term data, however, regarding the safety of continuous combined HRT. Of concern are reports of endometrial carcinoma arising in women receiving continuous HRT with low-dose progestin. Eight cases of women who developed endometrial carcinoma while on this regimen are presented. The possible increased risk of endometrial cancer associated with this regimen may be related to inadequate progestin dose, prior use of unopposed estrogen, poor patient compliance, use of less effective progestins, less efficient reversal of hyperplasia, and the use of progestin continuously.
激素替代疗法（HRT）可缓解更年期症状，逆转泌尿生殖系统萎缩性变化，预防骨质疏松症，并产生有益的脂蛋白效应。采用2.5毫克甲羟孕酮的连续联合HRT旨在通过消除撤退性出血来提高患者依从性，同时保留HRT的有益效果。然而，关于连续联合HRT安全性的长期数据有限。令人担忧的是，有报告称接受低剂量孕激素连续HRT的女性发生子宫内膜癌。本文介绍了8例在该治疗方案下发生子宫内膜癌的女性病例。与该治疗方案相关的子宫内膜癌风险可能增加，这可能与孕激素剂量不足、既往使用无对抗雌激素、患者依从性差、使用效果较差的孕激素、增生逆转效率较低以及持续使用孕激素有关。
