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目的评估早期子宫内膜癌行保留生育功能治疗的可行性、有效性和结局。方法回顾性分析北京协和医院自1998年6月～2004年12月接受保留生育功能治疗的12例早期子宫内膜癌患者的临床资料。结果患者年龄21～35岁,平均29岁。其中33.3%合并不孕,41.7%合并多囊卵巢综合征。高分化11例,高-中分化1例;FIGOⅠ_a期10例,Ⅰ_b期2例;孕激素受体阳性10例,阴性2例。安宫黄体酮500mg/d或己酸孕酮250mg/d治疗3～10个月,完全缓解9例(75%),无缓解3例(25%);完全缓解的9例中复发2例(22.2%);最后行子宫切除术5例。随诊36～108个月,12例均无瘤存活,无1例妊娠。结论保留生育功能治疗对于仔细选择的年轻子宫内膜癌妇女是可行的。由于病理完全缓解的患者在长期观察中的复发率仍高,故应强调密切随访。
Objective To evaluate the feasibility, effectiveness and outcome of the treatment of retained fertility in early endometrial cancer. Methods The clinical data of 12 patients with early endometrial carcinoma undergoing fertility maintenance function from June 1998 to December 2004 in Peking Union Medical College Hospital were retrospectively analyzed. Results Patients aged 21 to 35 years, mean 29 years. 33.3% were infertile, and 41.7% had polycystic ovary syndrome. There were 11 cases of high differentiation and 1 case of high-moderate differentiation. There were 10 cases of FIGOⅠ_a and 2 cases of stage Ⅰ_b. There were 10 cases of progesterone receptor positive and 2 cases negative. 9 cases (75%) were relieved and 3 cases (25%) were without remission in the treatment of An decoction progesterone 500mg / d or caproic progesterone 250mg / d for 3 ~ 10 months; 22.2%); the final hysterectomy in 5 cases. Follow-up 36 to 108 months, 12 cases were tumor-free survival, no 1 case of pregnancy. Conclusion Retention of fertility treatment is feasible for carefully selected young women with endometrial cancer. Due to the high recurrence rate in long-term observation of patients with pathologically complete remission, close follow-up should be emphasized.