化疗对卵巢恶性生殖细胞肿瘤术后患者卵巢功能的影响

目的:观察卵巢恶性生殖细胞肿瘤(MOGCT)患者行保留生育功能术后并进行化疗对卵巢功能的影响。方法:选取我院肿瘤科收治的45例MOGCT并行术后辅助化疗患者作为研究对象,选取同时期收治的年龄相近且具有生育需求并给予手术切除但术后未行化疗的45例卵巢良性肿瘤患者作为对照组,观察组给予BEP方案进行化疗,比较两组术前、术后6个月以及术后12个月的血清黄体生成素(LH)、促卵泡生成素(FSH)、雌二醇(E2)水平,观察化疗组患者化疗期间月经异常的发生情况。结果:术后6个月,对照组患者的LH、FSH、E2水平接近于正常水平,化疗组中的LH、FSH水平明显高于对照组,而E2水平则低于对照组,组间比较差异有显著性意义,术后12个月化疗组LH、FSH水平与6个月时相比明显下降,而E2水平显著升高,术后12个月,两组LH、FSH、E2水平组间比较无明显差异(P0.05)。在化疗期间,共有34例(75.6%)患者出现月经异常,其中有19例(42.2%)为停经,15例(33.3%)为月经量减少,随着化疗周期的延长,停经以及月经减少患者数量升高。结论:MOGCT患者在术后化疗期将出现性激素水平改变以及月经异常,主要表现为血清促性腺水平升高、雌激素水平下降、月经异常,但具有可逆性。

Effect on the postoperative ovarian function of patients with malignant ovarian germ cell tumor after chemotherapy

Objectives:To observe the effect on the postoperative ovarian function of patients with malignant ovarian germ cell tumor (MOGCT) after chemotherapy.Methods:45 MOGCT patients received postoperative chemotherapy in our hospital were selected as chemotherapy group,while 45 such patients at the same age but did not receive chemotherapy were selected as control group.The chemotherapy group received BEP scheme for postoperative chemotherapy.The preoperative,6-month and 12-month postoperative serum luteinizing hormone (LH),follicle-stimulating hormone (FSH),estradiol (E2) levels in the two groups were compared,and the incidence of irregular menstruation was recorded in the chemotherapy group.Results:At postoperative 6 months,the LH,FSH,E2 level of control group was close to normal level;the LH and FSH level in chemotherapy group was significantly higher than that of the control group,and E2 level was significantly lower,with statistically significant difference.At postoperative 12 months,the LH and FSH level in chemotherapy group significant decreased compared those at postoperative 6 months,while the E2 levels increased significantly,without significant difference between the two groups,P＞0.05.During chemotherapy,34 (75.56％) patients had abnormal menstruation,including 19 cases (42.22％) of menopause and 15 cases (33.33％) of decreased menstrual quantity.The number decreased as the ongoing of the chemotherapy.Conclusion:Patients with MOGCT are likely to encounter sex hormone level change and menstrual abnormalities during postoperative chemotherapy period,which are mainly elevated levels of serum gonadal,decreased estrogen levels and menstrual abnormalities,but it is reversible.