2017 年第 10 期 第 12 卷

来曲唑与他莫昔芬对绝经后乳腺癌切除术患者的治疗效果及其对子宫内膜厚度与子宫内膜病变的影响

Effects of letrozole and tamoxifen on endometrial thickness and endometrial lesions in postmenopausal patients with breast cancer resection

作者：虞宝中贺汉军侯艾林

英文作者：Yu Baozhong He Hanjun Hou Ailin

单位：628017四川省广元市第一人民医院药学部

英文单位：Department of Pharmacy Guangyuan First People′s Hospital Sichuan Province Guangyuan 628017 China

关键词：绝经后乳腺癌；来曲唑；他莫昔芬；子宫内膜厚度；子宫内膜病变

英文关键词：Postmenopausalbreastcancer;Letrozole;Tamoxifen;Endometrialthickness;Endometrialdisease

• 摘要：

• 目的 探讨来曲唑与他莫昔芬对绝经后乳腺癌切除术患者的治疗效果及其对患者子宫内膜厚度与子宫内膜病变的影响。方法 选取2013年3月至2016年3月期间入住四川省广元市第一人民肿瘤科的90例绝经后乳腺癌患者，均在本院进行了乳腺癌切除术。按照奇偶数字法将其均分为他莫昔芬组与来曲唑组，各45例。他莫昔芬组术后口服他莫昔芬片治疗1年；来曲唑组术后口服来曲唑片治疗1年。比较2组临床疗效、治疗前后血清肿瘤标志物水平、不同治疗时期子宫内膜厚度及子宫内膜活检情况。结果 治疗1年后，来曲唑组临床控制总有效率及临床收益率均明显高于他莫昔芬组［60.0%(27/45)比37.8%(17/45)、95.6%(43/45)比77.8%(35/45)］（P＜0.05）。2组患者术后1个月血清癌胚抗原及糖类抗原199水平均分别明显低于术前，来曲唑组患者术后1个月血清癌胚抗原及CA-199水平明显低于他莫昔芬组［（13±3）μg/L比（26±7）μg/L、（21±5）U/L比（46±9）U/L］（P＜0.05）。来曲唑组患者治疗6个月、1年后的子宫内膜厚度明显小于他莫昔芬组［（5.8±0.7）mm比（6.4±1.0）mm、（5.2±0.4）mm比（6.7±1.0）mm］（P＜0.05）。来曲唑组和他莫昔芬组患者治疗1年后子宫内膜活检阴性率为100.0%（45/45）和86.7%（39/45），组间差异无统计学意义（P＝0.065）。结论 来曲唑治疗绝经后乳腺癌较他莫昔芬效果更佳，可有效降低血清肿瘤标志物水平，使得子宫内膜变薄。

• Objective To investigate clinical efficacies of letrozole and tamoxifen treating postmenopausal patients after breast cancer resection and the effects on endometrial thickness and endometrial lesions. Methods A total of 90 postmenopausal patients with breast cancer who had surgical resection from March 2013 to March 2016 in Guangyuan First People′s Hospital were equally allocated to take tamoxifen or letrozole for 1 year after operation. Clinical efficacy, changes of serum tumor markers, endometrial thickness and endometrial biopsy results were analyzed. Results The total effective rate and clinical benefit rate after 1 year of treatment in letrozole group were significantly higher than those in tamoxifen group［60.0%（27/45） vs 37.8%（17/45）, 95.6%（43/45） vs 77.8%（35/45）］（P＜0.05）. At 1 month after operation, serum levels of carcinoembryonic antigen and carbohydrate antigen-199 significantly decreased compared to those before operation in both groups; there were also significant differences between letrozole group and tamoxifen group［（13±3）μg/L vs （26±7）μg/L, （21±5）U/L vs （46±9）U/L］（P＜0.05）. Endometrial thicknesses after 6 months and 1 year of treatment in letrozole group were significantly lower than those in tamoxifen group［（5.8±0.7）mm vs （6.4±1.0）mm, （5.2±0.4）mm vs （6.7±1.0）mm］（P＜0.05）. The negative rate of endometrial biopsy after 1 year of treatment had no significant difference between letrozole group and tamoxifen group［100.0%（45/45） vs 86.7%（39/45）］（P＝0.065）. Conclusion Letrozole is more effective in lowering serum tumor markers and attenuating endometrium than tamoxifen in treatment of postmenopausal breast cancer.