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目的:评估年轻妇女早期子宫内膜癌行保守治疗的可行性、有效性和结局。方法:回顾性分析广东省人民医院1996年8月至2006年10月10年间收治的年轻妇女早期子宫内膜癌保守治疗的10例患者的临床资料。结果:患者年龄20～35岁,中位年龄28.5岁。4例患者合并不孕症,5例合并多囊卵巢综合征;FIGOⅠA期9例,ⅠB期1例;高分化9例,高-中分化1例;孕激素受体阳性8例,阴性2例。6例在激素治疗平均5.5个月(范围3～8个月)时获得完全缓解,部分缓解1例,无反应3例。完全缓解的患者中促排卵治疗2例,未妊娠;复发1例。最终行子宫切除术4例。随诊9～50个月,所有患者无瘤存活。结论:应用大剂量孕激素治疗年轻妇女早期子宫内膜癌是可行的。即使病理完全缓解,也有复发可能,应密切随访。
PURPOSE: To assess the feasibility, efficacy and outcome of conservative treatment in early stage endometrial cancer in young women. Methods: The clinical data of 10 patients with conservative treatment of early endometrial cancer in young women admitted to Guangdong Provincial People’s Hospital from August 1996 to October 2006 were retrospectively analyzed. Results: The patients were 20 to 35 years old with a median age of 28.5 years. 4 patients with infertility, 5 patients with polycystic ovary syndrome; FIGO Ⅰ A period of 9 cases, Ⅰ B period in 1 case; 9 cases of high differentiation, high-moderate differentiation in 1 case; progesterone receptor positive in 8 cases, negative in 2 cases . Six patients achieved complete remission in hormone therapy for an average of 5.5 months (range 3 to 8 months), with partial remission in 1 case and no response in 3 cases. Ovulation treatment in 2 patients with complete remission, non-pregnancy; recurrence in 1 case. The final hysterectomy in 4 cases. Follow-up 9 to 50 months, all patients without tumor survival. Conclusion: It is feasible to use high-dose progestin to treat early stage endometrial cancer in young women. Even if the pathology is completely relieved, there is a possibility of recurrence and should be followed up closely.