绝经前、绝经后及他莫西芬相关性子宫内膜息肉的研究进展

doi:10.12280/gjfckx.20230805

摘要/Abstract

摘要：

子宫内膜息肉（endometrial polyp，EP）是子宫内膜的常见病变，在临床上可分为绝经前EP、绝经后EP以及他莫西芬（Tamoxifen，TAM）相关性EP。不同类型的EP在临床特征及治疗等方面不尽相同。年龄的增长、绝经以及使用TAM是EP发病与恶变的高危因素。由于受女性体内激素水平等不同因素的影响，3种类型EP的甾体激素受体的表达也不同。绝经前EP通常呈现经典的EP病理特征，绝经后EP具有更丰富的间质，TAM相关性EP可伴有不典型增生和癌变。超声下绝经前EP通常为均匀的高回声团块，绝经后EP常可见大小不等的多发囊性灶，TAM相关性EP常可见密集分布的蜂窝状液性暗区。不同类型EP的治疗需根据患者是否绝经、有无症状、有无生育要求、有无恶变风险等进行个体化管理。

关键词: 子宫内膜息肉, 绝经前期, 绝经后期, 他莫西芬, 超声检查, 治疗

Abstract:

Endometrial polyp (EP) is a common lesion of the endometrium, which can be classified as premenopausal EP, postmenopausal EP, and Tamoxifen (TAM)-associated EP. Different types of EP have different clinical features and treatment. Ageing, menopause, and the use of TAM are high-risk factors for the development and malignancy of EP. The expression of steroid hormone receptors varies among the three types of EP due to the influence of different factors such as hormone levels in women. Premenopausal EP usually exhibits the classic pathological features of EP, postmenopausal EP has a richer mesenchymal stroma, and TAM-associated EP may be accompanied by atypical hyperplasia and carcinoma. Premenopausal EP is usually a homogeneous hypoechoic mass on ultrasound, while postmenopausal EP often shows multiple cystic foci of varying sizes, and TAM-associated EP often shows densely distributed honeycomb-like liquid dark areas. The treatment approaches for different types of EP are not entirely the same and should be personalized based on factors such as whether the patient is menopausal or not, with or without symptoms and fertility requirements, and risk of malignancy.

Key words: Endometrial polyp, Premenopause, Postmenopause, Tamoxifen, Ultrasonography, Therapy

王启琴, 王湘炼, 潘思怡, 王秀丽. 绝经前、绝经后及他莫西芬相关性子宫内膜息肉的研究进展[J]. 国际妇产科学杂志, 2024, 51(2): 137-141.

WANG Qi-qin, WANG Xiang-lian, PAN Si-yi, WANG Xiu-li. Research Progress of Premenopausal Endometrial Polyps, Postmenopausal Endometrial Polyps and Tamoxifen-Associated Endometrial Polyps[J]. Journal of International Obstetrics and Gynecology, 2024, 51(2): 137-141.

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