孕激素与二甲双胍联合米菲司酮治疗子宫内膜癌的疗效以及对生殖激素的影响

To investigate the efficacy of progesterone and metformin combined with mifepristone in treatment for endometrial cancer and its effect on reproductive hormones

摘要:

目的 探讨孕激素与二甲双胍联合米菲司酮治疗子宫内膜癌的疗效以及对生殖激素的影响。方法 按照随机数字表法抽取新乡市第二人民医院2020年1月至2021年12月因子宫内膜癌入院的72名患者，分为对照组和观察组，各36例。对照组使用孕激素与二甲双胍治疗子宫内膜癌，观察组在对照组的基础上加用米菲司酮，比较两组患者的疗效、生殖激素［促卵泡激素（FSH）、黄体生成素（LH）、泌乳素（PRL）、雌二醇（E₂）、孕醇（P）、睾酮（T）］的水平以及肿瘤标志物水平［血清糖类抗原125（CA125）和人附睾蛋白4（HE4）］、恶性肿瘤生存质量量表（QOL）评分。结果 观察组患者的疾病缓解率为83.33％，对照组患者的疾病缓解率为58.33％，差异有统计学意义（P<0.05）；治疗后，观察组FSH、LH、T激素水平均低于对照组（P<0.05）；观察组与对照组PRL、E₂、P激素水平比较，差异无统计学意义（P>0.05）；治疗后，两组CA125、HE4值均降低，且观察组与对照组比较，CA125、HE4值更低（P<0.05）；治疗后两组患者生存质量皆有所改善，且观察组改善情况优于对照组（P<0.05）。结论 孕激素与二甲双胍联合米非司酮治疗子宫内膜癌能够调节生殖激素水平，加强抗癌细胞作用，抑制并促进癌细胞凋亡，提高患者的生活质量，具有较好的临床效果。

Abstract:

Objective To investigate the effect of progesterone and metformin combined with mifepristone in the treatment of endometrial cancer and its influence on reproductive hormones.Methods Seventy-two patients admitted to the Second People's Hospital of Xinxiang due to endometrial cancer from January 2020 to December 2021 were selected using the random number table approach and were split into two groups: a control group (36 cases) and an observation group (36 cases). The control group was treated with progesterone and metformin for endometrial cancer, while the observation group received mifepristone in addition to the control group. The levels of reproductive hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E₂), progesterone (P), testosterone (T)], tumor marker levels [serum carbohydrate antigen 125 (CA125) and human epididymal protein 4 (HE4)], quality of life (QOL) score of malignant tumor quality of life survey, and the curative effect were compared between the two groups.Results The disease remission rate was 83.33% in the observation group and 58.33% in the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of FSH, LH and T hormones in the observation group were lower than those in the control group, with statistical significance (P<0.05). There was no statistical significance in the levels of PRL, E₂ and P hormones between the observation group and the control group (P>0.05). After treatment, the CA125 and HE4 values of both groups were decreased, and the CA125 and HE4 values of the observation group were lower than those of the control group, the difference was statistically significant (P<0.05). After treatment, the quality of life of both groups was improved, and the improvement in the observation group was better than that in the control group, with statistical significance (P<0.05).Conclusion In the treatment of endometrial carcinoma, progesterone and metformin combined with mifepristone can regulate the level of reproductive hormone, strengthen the effect of anticancer cells, inhibit and promote the apoptosis of cancer cells, improve the quality of life of patients, and have good clinical effects.