Lum S S, Woltering E A, Fletcher W S, Pommier R F
Department of Surgery, Oregon Health Sciences University, Portland 97201, USA.
Am J Surg. 1997 May;173(5):399-402. doi: 10.1016/S0002-9610(97)00072-X.
Tamoxifen is considered an antiestrogen against breast cancer, yet it has known estrogenic side effects. We hypothesized that long-term administration of tamoxifen may significantly increase circulating estrogen levels in women with breast cancer.
Serum dehydroepiandrosterone (DHEA), estrone (E1), and estradiol (E2) levels were prospectively measured in 47 breast cancer patients before and during tamoxifen therapy for 2 years. Differences in baseline and peak hormone levels during treatment were compared, and significance was determined by paired Student's t test.
Mean DHEA levels increased by 133% from 61 mg/L to 142 mg/L (P <0.001) and mean E2 levels increased by 239% from 28 pg/mL to 95 pg/mL (P <0.05). Mean E1 levels increased by 264% from 42 pg/mL to 153 pg/mL (P = 0.06).
Long-term tamoxifen therapy can be associated with increased serum levels of DHEA, E1, and E2. Elevated serum estrogens may explain tamoxifen's estrogenic effects and may represent a mechanism for the development of drug resistance.
他莫昔芬被认为是一种抗雌激素药物用于治疗乳腺癌，但已知其有雌激素样副作用。我们推测长期服用他莫昔芬可能会显著提高乳腺癌女性患者的循环雌激素水平。
前瞻性地测量了47例乳腺癌患者在接受他莫昔芬治疗前及治疗2年期间血清脱氢表雄酮（DHEA）、雌酮（E1）和雌二醇（E2）水平。比较了治疗期间基线和激素峰值水平的差异，并通过配对t检验确定其显著性。
DHEA平均水平从61mg/L增至142mg/L，升高了133%（P<0.001），E2平均水平从28pg/mL增至95pg/mL，升高了239%（P<0.05）。E1平均水平从42pg/mL增至153pg/mL，升高了264%（P = 0.06）。
长期他莫昔芬治疗可能与血清DHEA、E1和E2水平升高有关。血清雌激素升高可能解释了他莫昔芬的雌激素样作用，并可能是耐药性产生的一种机制。
