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性腺发育不全的病人接受雌激素治疗而发生子宫体腺癌的报道使人们对这种治疗的安全性产生了疑问。在这些报道中大部分病人是长期服用大剂量的雌激素。在性腺发育不全的病人须要较长时间用雌激素治疗,虽不须大剂量,但对多年应用小剂量的安全性仍有怀疑。为了找出哪种情况与发生癌的危险有关,作者对21例病人的宫内膜进行了研究。 14例单纯服用乙炔雌二醇,每4周中连续服药3周,疗程在2年以上。另7例先单服乙炔雌二醇2周,第三周合用孕激素,疗程在3年以上。这些病人都在服药的第三周作刮宫。宫内膜检查发现单用雌激素的14例中有7例呈囊性腺体增殖,有1例在增殖的宫内膜中发现有不典型改变。余下7例都是增生期宫内膜,在此7例中有1例宫内膜呈轻度
The report of gonadal adenocarcinoma in patients with gonadal dysgenesis receiving estrogen therapy raised questions about the safety of this treatment. Most of these patients reported long-term use of high-dose estrogen. Patients with gonadal dysgenesis need longer treatment with estrogen, although the need for large doses, but for many years the use of low-dose safety is still in doubt. In order to find out which situation is related to the risk of developing cancer, the authors studied the endometrium of 21 patients. Of the 14 patients who took ethinyl estradiol alone, they took medication continuously for 3 weeks every 4 weeks for more than 2 years. Another 7 cases first single oral ethinyl estradiol 2 weeks, the third week combined with progesterone, treatment in more than 3 years. These patients are in the third week of medication for curettage. Endometrial examination found that only 14 of 14 cases of estrogen cystic gland proliferation, and 1 case of proliferative endometrial found in atypical changes. The remaining 7 cases were proliferative endometrium, in which 1 case of endometrial was mild