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논문 기본 정보

자료유형
학술저널
저자정보
Bingyi Yang (Hospital of Fudan University Shanghai China) Liying Xie (Fudan University Shanghai China) Hongwei Zhang (Fudan University Shanghai China) Qin Zhu (Fudan University Shanghai China) Yan Du (Fudan University Shanghai China) Xuezhen Luo (Obstetrics and Gynecology Hospital of Fudan University) Xiaojun Chen (Obstetrics and Gynecology Hospital of Fudan University)
저널정보
대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.29 No.3
발행연도
2018.1
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1 - 12 (12page)

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Objective: Our previous study showed that insulin resistance (IR) was related to endometrial hyperplasia as well as endometrial cancer. But the exact impact of IR on fertility-sparing treatment in endometrial hyperplasic disease is unclear. This study investigated how IR affects fertility-sparing treatment in endometrial atypical hyperplasia (EAH) patients. METHODS: The 151 EAH patients received fertility-sparing treatment were retrospectively investigated. All patients received high-dose progestin combined with hysteroscopy. Therapeutic effects were evaluated by hysteroscopy every 3 months during the treatment. RESULTS: The median age was 33.0 years old (range, 21-54 years old). Sixty-one patients (40.4%) were insulin resistant. Three patients were excluded from the analysis because they chose hysterectomy within 3 months after initiation of progestin treatment. The 141 out of 148 (95.3%) patients achieved complete response (CR). No difference was found in cumulative CR rate between those with or without IR (90.2% vs. 95.6%, p=0.320). IR significantly affected therapeutic duration to achieve CR (8.1±0.5 months with IR vs. 6.1±0.4 months without IR, p=0.004). Overweight (body mass index [BMI]≥25 kg/m²) was associated with higher risk of treatment failure (odds ratio=5.61; 95% confidence interval=1.11-28.35; p=0.040) and longer therapeutic duration to achieve CR (7.6±0.5 months vs. 6.3±0.4 months, p=0.019). EAH patients with both IR and overweight (IR+BMI+) had the longest therapeutic time compared with other patients (8.8±0.6 months vs. 5.6±0.7, 6.3±0.4, and 6.4±0.8 months for IR-BMI+, IR-BMI-, and IR+BMI-, respectively, p=0.006). CONCLUSION: IR and overweight were associated with longer therapeutic duration in EAH patients receiving progestin-based fertility-sparing treatment.

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참고문헌 (34)

참고문헌 신청
Shan W / 2014 / Hyperinsulinemia is associated with endometrial hyperplasia and disordered proliferative endometrium: a prospective cross-sectional study / Gynecol Oncol 132:606~610 Crossref Mitsuhashi A / 2017 / Prospective evaluation of abnormal glucose metabolism and insulin resistance in patients with atypical endometrial hyperplasia and endometrial cancer / Support Care Cancer 25:1495~1501 Crossref Ning C / 2016 / Infiltrating macrophages induce $ER{\alpha}$ expression through an IL17A-mediated epigenetic mechanism to sensitize endometrial cancer cells to estrogen / Cancer Res 76:1354~1366 Crossref Eftekhar Z / 2009 / Efficacy of megestrol acetate (megace) in the treatment of patients with early endometrial adenocarcinoma: our experiences with 21 patients / Int J Gynecol Cancer 19:249~252 Crossref Simpson AN / 2014 / Fertility sparing treatment of complex atypical hyperplasia and low grade endometrial cancer using oral progestin / Gynecol Oncol 133:229~233 Crossref

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