| 摘要: |
| 目的:探讨经阴道超声监测服用他莫昔芬TAM的乳腺癌患者子宫内膜病变的有效方法。材料和方法:回顾分析2010年1月-2019年1月首都医科大学附属北京妇产医院和北京市大兴区人民医院共94例乳腺癌术后服用TAM病人,对可疑子宫内膜病变者实行诊刮或手术获得组织病理学结果,进行病理与经阴道超声结果对照分析。结果:94例乳腺癌病人中,子宫内膜病理良性组78例(包括正常内膜8例、增生及复杂增生32例、息肉及息肉样增生28例及萎缩内膜10例),恶性组16例(包括非典型增生5例,高分化腺癌2例,中低分化腺癌5例,浆液性癌2例,恶性中胚叶混合瘤1例,透明细胞癌1例)。两组病人经阴道超声资料比较,在子宫内膜回声,内膜是否出现小囊性改变,内膜是否出现息肉样变,内膜与肌层界限情况及出现宫腔积液情况等指标上存在明显差异。而在子宫内膜厚度上差异不明显。结论:乳腺癌术后服用TAM病人经阴道超声检查如出现子宫内膜回声不均、子宫内膜出现息肉样变、内膜与肌层界限不清及宫腔积液者要高度警惕子宫内膜发生恶变可能,应提示临床尽早刮宫行组织病理学检查,而子宫内膜出现小囊变则良性内膜发生几率高。单纯依靠子宫内膜厚度测量尚不能做为超声判断子宫内膜良恶性的指标。 |
| 关键词: 乳腺癌 TAM 子宫内膜 经阴道超声 |
| DOI： |
| 投稿时间：2020-04-19修订日期：2020-04-27 |
| 基金项目: |
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| The value of transvaginal ultrasound in monitoring endometrial lesions in breast cancer patients treated with TAM |
| liujingyan,wuqingqing,wangjingjing |
| (Beijing daxing district people''s hospital;Beijing Obstetrics and Hynecology Hospital;Capital Medical University) |
| Abstract: |
| Objective: to investigate the effective method of transvaginal ultrasound monitoring endometrial lesions in breast cancer patients treated with tamoxifen TAM.Materials and methods: retrospective analysis in January 2010 - January 2019 maternity hospital affiliated to the capital university of medical sciences, Beijing, and Beijing daxing district people"s hospital, a total of 94 cases of postoperative breast cancer patients taking TAM, for suspected endometrial lesions for medical or surgical histopathological results were, pathology and transvaginal ultrasound results contrast analysis.Results: 94 cases of breast cancer patients, 78 cases of endometrial pathologic benign group (including normal endometrium, 8 cases, hyperplasia and complex hyperplasia of 32 cases, 28 cases polyps and polypoid hyperplasia and 10 cases of atrophic endometrium), 16 cases of malignant group (including 5 cases with atypical hyperplasia, well-differentiated adenocarcinoma in 2 cases, 5 cases were low differentiated adenocarcinoma, serous carcinoma 2 cases, malignant mesoderm mixed tumor 1 case, clear cell carcinoma 1 case).The comparison of transvaginal ultrasound data between the two groups showed that there were significant differences in endometrial echogenicity, whether the endometrial had small cystic changes, whether the endometrial had polypoid changes, the boundary between the endometrial and muscular layer, and the presence of intrauterine effusion.There was no significant difference in endometrial thickness.Conclusion: postoperative breast cancer patients taking TAM transvaginal ultrasound examination such as endometrial echo inequality, endometrial appears polypoid change, lining and muscle layer boundary is not clear and uterine cavity accumulates fluid to possible endometrial enough, should prompt clinical histopathological examination and curettage line as soon as possible, while endometrial occurrence utricle is benign endometrium high risk. |
| Key words: breast cancer TAM Endometrium Transvaginal ultrasound |
