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相關文獻
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題名 | Uterine Myoma after Cessation of Gonadotropin-Releasing Hormone Agonist: Ultrasound and Histopathologic Findings=良性子宮肌瘤經性腺釋放激素激動物(GnRH agonist)治療後之超音波和細胞組織學變化 |
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作者 | 王鵬惠; 楊安航; 袁九重; 李文齡; 趙湘臺; | 書刊名 | 中華醫學雜誌 |
卷期 | 61:11 1998.11[民87.11] |
頁次 | 頁625-629 |
分類號 | 417.281 |
關鍵詞 | 血管血流動力學; 性腺釋放激素激動物; 細胞形態; 子宮肌瘤; Flow velocity waveform; Gonadotropin-releasing hormone agonist therapy; Morphometry; Ultrastructure; Uterine myoma; |
語文 | 英文(English) |
中文摘要 | 背景 良性子宮肌瘤經性腺釋放激素激動物(GnRH agonist)治療後,雖然可得到某 種程度的療效,但一旦停藥,這些良性子宮肌瘤不久又會快速長回原來之大小,甚至更大。 為明療這些良性子宮肌瘤經性腺釋放激素激動物治療後之細胞組織學變化,探討此類藥物對 腫瘤細胞的影響及機轉,我們設計了以下研究。 方法 前瞻性選擇5位尚未停經且有症狀的良性子宮肌瘤病人,接受性腺釋放激素激動 物goserelin 3.6mg治療,每4週為一療程,為期16週。治療前、治療中、治療後病人均接 受超音波和荷爾蒙之檢查。完成治療後,病人接受子宮肌瘤切除術,並將所切下的標本做光 學及電子顯微鏡之研究。 結果 子宮及子宮肌瘤體積明顯縮小,前者縮小21-57%,後者縮小21-65%。杜卜勒超 音波顯示,供給腫瘤之血管阻力並無變化。雌激素(E2)則在第二次針劑注射時達停經值(<25 pg/ml)。顯微鏡下之腫瘤細胞形態顯示:細胞明顯萎縮伴隨有細胞內部肌纖維蛋白流失,但 整個細胞結構仍屬完整。 結論 子宮肌瘤經性腺釋放激素激動物治療後,並無細胞結構之破壞,這可能為停藥後 腫瘤復發的原因。 |
英文摘要 | Background. This study attempted to search for the possible mechanism of regrowth of uterine myoma after cessation of gonadotropin-releasing hormone agonist (GnRHa) therapy. Methods. Five premenopausal women presenting with symptomatic uterine myoma were prospectively studied in this trial. All patients were treated with a subcutaneous injection of goserelin depot 3.6 mg every four weeks for 16 weeks . Clinical examinations as well as hormonal and ultrasound determinations were performed before, during and after treatment to monitor the efficacy of therapy. At the end of the treatment period, all patients underwent myomectomy. The ultrastructural change of the myoma was evaluated postoperatively. Results. The volume of the uterus decreased 21-57% and the volume of the uterine myoma decreased 21-65% after therapy. There was no significant change in resistance index of the uterine vessels or major vessels supplying the uterine myoma between pretreatment and post-treatment values. The morphologic features of the treated myoma showed marked cellular shrinkage and loss of myofibrillar structure. Conclusions. There is no significant cellular damage to the cellular structure that contributes to regrowth of treated intramural uterine myoma following cessation of treatment. |
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