化疗对围绝经期乳腺癌患者性激素水平的影响

摘要

Background and purpose: It is difficult to distinguish menopausal or amenorrhea in patients with breast cancer after adjuvant chemotherapy. We aimed to investigate the effect of postoperative adjuvant chemotherapy on gonadal hormone of patients with breast cancer during peri-menopausal period, to provide evidence for selection of drugs in endocrine therapy of breast cancer. Methods: The patients with breast cancer during peri-menopausal period were divided into 2 groups, Group 1 (45-50 years old, n=44) and Group 2 (51-55 years old, n=56). The level of serum FSH and E2 were examined after 6 courses of postoperative adjuvant chemotherapy. The level of serum FSH and E2 were also examined 3 and 6 months later, the change of gonadal hormone were analyzed. Results: In Group 1, the FSH and E2 of only 2.3% patients were at peri-menopausal period level after 6 courses of postoperative adjuvant chemotherapy; In Group 2, the FSH and E2 of 76.78% patients were at peri-menopausal period level. Conclusion: If the breast cancer patients received postoperative adjuvant chemotherapy during peri-menopausal period last one year or more, and the level of serum FSH and E2 were at peri-menopausal period level, the patients may enter menopause.%背景与目的:目前围绝经期乳腺癌化疗后的闭经与绝经容易混淆.本研究探讨围绝经期乳腺癌患者术后辅助化疗对性激素水平的影响,为乳腺癌辅助内分泌治疗药物的选择提供依据.方法:将100例围绝经期乳腺癌患者分为45～50岁组(n=44)及51～55岁组(n=56),术后均行辅助化疗6个疗程.分别于化疗前、化疗结束时、化疗结束后3个月及6个月检测卵泡刺激激素(follicle-stimulating hormone,FSH)及雌二醇(estradiol,E2)的水平,分析围绝经期乳腺癌患者性激素水平的变化.结果:经6个疗程辅助化疗后,45～50岁组患者中,6个月后血清FSH及E2仅有2.3％处于绝经期水平,而51～55岁组血清FSH及E2有76.78％处于绝经期水平,差异有统计学意义(P＜0.05).结论:围绝经期乳腺癌患者化疗后停经持续1年以上,且血清FSH及E2处于绝经期水平,尤其50岁以上可考虑为已绝经.