子宫内膜癌术后激素替代治疗对肿瘤预后的影响——一项小样本的配对研究

目的探讨子宫内膜癌术后激素替代治疗（HRT）对肿瘤预后的影响。方法收集1983年1月至2005年12月期间，北京协和医院收治的年龄小于50岁、手术绝经的子宫内膜癌患者76例，按照患者的年龄段、接受治疗年限，以1：2匹配研究组和对照组。共收集到术后行HRT的患者17例，设为研究组。匹配未接受HRT的患者34例，设为对照组。对上述51例患者的临床资料进行回顾性分析和统计学检验。结果研究组1例复发（5．9％），对照组4例复发（11．8％），两组间差异无统计学意义（P=0．654）。病例组无瘤缓解期（64．00±33．20）月，对照组（49．38±36．97）月，两组间差异无统计学意义（P=0．346）。多因素Cox回归模型分析，HRT不是患者术后复发的独立危险因素（P=0．338）。结论对于Ⅰ期子宫内膜癌患者术后行HRT未增加肿瘤的复发率。

Effect of hormone replacement therapy on the prognosis of endometrial adenocarcinoma after surgical menopause

Objective： To investigate the effect of hormone replacement therapy on the prognosis of endornetrial adenocarcinoma after surgical menopause. Methods： Seventy-six patients younger than 50 years with endometrial adenocareinoma received surgical management in Peking Union Medical College Hospital from January 1983 to December 2005. All the patients were classified as surgical stage I, with more than 6 months of postoperative follow-up. Seventeen patients who took hormone replacement therapy （HRT） after surgery served as study group, while 34 matched patients without HRT as control. The clinical data of these 51 patients were analyzed retrospectively. Results： The recurrence rates in the study group and Control group were 5. 9% and 11. 7% respectively, with no statistical difference between two groups （P=0. 654）. The overall survival time was 64.00±33.20 months in the study group, while 49.38±36.97 months in the control, with no statistical difference （P = 0. 346）. Multivariate Cox regression model analysis showed that hormone replacement therapy was not an independent prognostic factor for recurrence （P=0. 338）. Conclusions： Postoperative hormone replacement therapy may not increase the incidence of relapse in the patients with endometrial adenocarcinoma.