中国实用妇科与产科杂志

中国实用妇科与产科杂志 ›› 2022, Vol. 38 ›› Issue (11): 1068-1074.DOI: 10.19538/j.fk2022110103

• 专题笔谈 • 上一篇    下一篇

早期子宫内膜癌生育力保护的治疗和长期管理

  

  1. 北京协和医院妇科肿瘤中心，北京 100730 
  • 出版日期:2022-11-02 发布日期:2022-11-02
  • 通讯作者: 潘凌亚
  • 基金资助:
    中国医学科学院科学创新基金（CIFMS-2017-I2M-1-002）

Treatment and long-term management of fertility-sparing in early-stage endometrial cancer. 

  1. Department of Obstetrics and Gynecology，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences & Peking Union Medical College，Beijing，100730，China. National Clinical Research Center for Obstetric & Gynecologic Diseases，Peking Union Medical College Hospital，Beijing 100730，China
  • Online:2022-11-02 Published:2022-11-02

摘要： 强烈渴望保留生育功能的高分化子宫内膜样癌、无肌层浸润的年轻患者可以保留生育功能。可采用的治疗方案包括：体重管理、大剂量孕激素、左炔诺孕酮宫内缓释系统、其他抗雌激素类药物［促性腺激素释放激素激动剂（GnRH-a）或芳香化酶抑制剂］、宫腔镜病灶切除手术以及二甲双胍治疗。辅助生殖技术可以显著增加患者的妊娠率，并且不影响患者生存。在完成生育功能后需进行根治性手术，年轻患者可考虑保留双侧卵巢。

关键词: 子宫内膜肿瘤, 保留生育功能, 治疗方案, 患者管理

Abstract: Young patients，who have a strong desire to preserve fertility and are diagnosed with grade 1 endometrioid carcinoma without myometrium invasion，may receive fertility-sparing therapy.  Treatment regimens include weight management，high-dose progesterone，levonorgestrel intrauterine device，other antiestrogens（gonadotrophin releasing hormone agonist，GnRH-a or aromatase inhibitors，AIs），hysteroscopic resection，and metformin. Assisted reproductive technology can significantly increase the pregnancy rate without affecting survival. Radical surgery is needed after the completion of reproduction，and bilateral ovaries can be retained for young patients.

Key words: endometrial neoplasm, fertility-sparing therapy, therapeutic regimen, patient management

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