CAJ | 학술논문

目的：探讨外周血雌激素（E2）水平与三苯氧胺治疗ER+乳腺癌疗效关系。方法对我院收治的50例经病理证实的手术后ER+乳腺癌患者进行内分泌治疗（A组），其中绝经前患者（A1组）28例，绝经后患者（A2组）22例；同时设立对照组：良性乳腺疾病（B组）和健康体检（C组）各50例。治疗前、后进行血清E2检测。结果治疗前，A组血清E2水平明显低于B组、C组（P＜0.05）。 A组三苯氧胺治疗前血清E2水平低于治疗后（P＜0.05）；B组手术前血清E2与术后血清E2无显著性差异（P＞0.05）。三苯氧胺治疗后，A组患者血清E2水平升高的7例中，其中A1组6例（占21.43%），A2组1例（4.54%），A1组血清E2水平升高的例数及水平6例显著高于A2组（P＜0.05）。A组三苯氧胺治疗后总有效率70.0%（35/50）。血清E2升高与血清E2正常的患者近期有效率（CR+PR）分别为28.57%（2/7例）、76.74%（33/43例），两组比较Hc=3.021,差异有显著性（P＜0.05）。血清E2升高7例患者中，以浸润性导管癌乳腺癌居多，且TNM分期晚，内分泌治疗效果较差（P＜0.05）。结论三苯氧胺抑制后雌激素水平低的患者，治疗疗效好，相反在三苯氧胺治疗过程中，雌激素水平一直高居不下或者在治疗过程中出现雌激素水平最高者，往往治疗失败。
목적：탐토외주혈자격소（E2）수평여삼분양알치료ER+유선암료효관계。방법대아원수치적50례경병리증실적수술후ER+유선암환자진행내분비치료（A조），기중절경전환자（A1조）28례，절경후환자（A2조）22례；동시설립대조조：량성유선질병（B조）화건강체검（C조）각50례。치료전、후진행혈청E2검측。결과치료전，A조혈청E2수평명현저우B조、C조（P＜0.05）。 A조삼분양알치료전혈청E2수평저우치료후（P＜0.05）；B조수술전혈청E2여술후혈청E2무현저성차이（P＞0.05）。삼분양알치료후，A조환자혈청E2수평승고적7례중，기중A1조6례（점21.43%），A2조1례（4.54%），A1조혈청E2수평승고적례수급수평6례현저고우A2조（P＜0.05）。A조삼분양알치료후총유효솔70.0%（35/50）。혈청E2승고여혈청E2정상적환자근기유효솔（CR+PR）분별위28.57%（2/7례）、76.74%（33/43례），량조비교Hc=3.021,차이유현저성（P＜0.05）。혈청E2승고7례환자중，이침윤성도관암유선암거다，차TNM분기만，내분비치료효과교차（P＜0.05）。결론삼분양알억제후자격소수평저적환자，치료료효호，상반재삼분양알치료과정중，자격소수평일직고거불하혹자재치료과정중출현자격소수평최고자，왕왕치료실패。
Objective To explore the relationship between peripheral blood level of estrogen(E2) and Tamoxifen for ER+breast cancer. Methods 50 patients pathologically confirmed after surgery as ER+breast cancer were received endocrine therapy (as A group). including Premenopausal patients(A1)28 cases,22 cases of postmenopausal patients (A2);and there were 2 control groups. Serum E2 was detected before treatment. Results Before treatment,serum E2 level in group A was significantly lower than in group B and group C (P<0.05). Serum E2 levels before Tamoxifen treatment was lower than(P<0.05) after treatment in group A;Serum E2 in group B before and after surgery had no significant difference (P>0.05). After Tamoxifen treatment,7 cases of group A patients increased serum E2 levels, 6 cases in A1 group (21.43%),1 patient in A2 Group (4.54%),6 cases of E2 level in A1 was signifi-cantly higher than A2 (P<0.05). In group A,the total effective rate was 70.0%(35/50). Recent response rate (CR+PR) were 28.57%(2/7) and 76.74% (33/43 cases) in patients with elevated serum E2 and normal serum E2. Hc=3.021 and the difference was signifi-cant(P<0.05). 7 cases of elevated serum E2,the majority was invasive ductal carcinoma,and TNM stage was late and endocrine therapy was less effective(P<0.05). Conclusion Breast cancer patients with low estrogen levels after treatment are more effective, and patients with higher estrogen levels often fails the treatment.