通讯作者: 崔树娜, sncui@yzu.deu.cn

DOI：10.12201/bmr.202512.00077

Risk factors of endometrial lesions detected in patients taking tamoxifen after breast cancer surgery

• 摘要：目的 讨论乳腺癌术后服用他莫昔芬（TAM）患者检出子宫内膜病变的危险因素。方法 选取2021年1月至2024年3月在本院服用TAM治疗的乳腺癌术后患者200例为研究对象，收集患者病历资料，统计子宫内膜病变检出率，并采用多因素Logistic回归分析探讨此类患者检出子宫内膜病变的危险因素。最后采用ROC曲线分析相关指标联合对子宫内膜病变的预测价值。结果 以组织病理学检查结果为诊断“金标准”，纳入的200例服用TAM治疗的乳腺癌术后患者，共检出子宫内膜病变48例，检出率为24.00%，其中子宫内膜息肉、子宫内膜不典型增生、子宫内膜肌瘤以及子宫内膜癌分别为12例、21例、10例以及5例。单因素分析显示，子宫内膜病变组患者已绝经、TAM用药剂量为40mg/d、TAM用药时间≥24个月、AUB/PMB、术后子宫内膜厚度≥5mm以及宫腔内高回声占位的占比均高于正常组（P＜0.05）。TAM用药剂量40mg/d（OR=4.332）、TAM用药时间≥24个月（OR=4.267）、AUB/PMB（OR=5.265）、子宫内膜厚度≥5mm（OR=4.963）以及宫腔内高回声占位（OR=3.789）是乳腺癌术后服用TAM患者子宫内膜病变发生的危险因素。TAM用药剂量40mg/d、TAM用药时间≥24个月、AUB/PMB、子宫内膜厚度≥5mm以及宫腔内高回声占位联合应用评估子宫内膜病变的AUC值高于单项检测（Z=4.497、2.281、2.116、2.168、2.679，P＜0.05）。结论 接受 TAM 治疗的乳腺癌术后患者，子宫内膜病变的发生风险处于较高水平。其中TAM用药剂量40mg/d、TAM用药时间≥24个月、AUB/PMB、子宫内膜厚度≥5mm以及宫腔内高回声占位是其主要危险因素，上述指标联合评估患者子宫内膜病变的价值较高，应加强针对性干预，以预防子宫内膜病变的发生。

  关键词： 乳腺癌术后；他莫昔芬；子宫内膜病变；危险因素; ; ; 

   

  Abstract: Objective A study is designed to explore the risk factors of endometrial lesions that arise in breast cancer postoperative patients administered with tamoxifen (TAM). Methods From January 2021 to March 2024, 200 patients with postoperative breast cancer who received TAM treatment in our hospital were selected as the study objects. Using multivariate logistic regression on patient records, we determined the endometrial lesion detection rate and explored its risk factors in post-operative breast cancer patients on tamoxifen. Results Using histopathological examination as the gold standard for diagnosis, 48 cases of endometrial lesions were detected in 200 patients with postoperative breast cancer treated with TAM, and the detection rate was 24.00%. Included were 12 endometrial polyps, 21 atypical hyperplasia, 10 myomas and 5 endometrial cancer cases. Univariate analysis showed that the proportion of menopausal patients, TAM dose of 40mg/d, TAM duration of ≥24 months, AUB/PMB, postoperative endometrial thickness ≥5mm and intrauterine hyperechoic space in endometrial disease group were higher than those in normal group (P＜0.05). Age, body mass index, history of hypertension, history of diabetes, frequency of delivery, pathological type, and proportion of postoperative chemotherapy were compared between the two groups (P > 0.05). Daily TAM dose of 40 mg (OR=4.332), treatment duration ≥24 months (OR=4.267), AUB/PMB (OR=5.265), endometrial thickness ≥5 mm (OR=4.963) and intrauterine hyperechoic lesions (OR=3.789) are risk factors for endometrial lesions in breast cancer patients on postoperative TAM therapy. Combined application of TAM dose 40mg/d, TAM duration ≥24 months, AUB/PMB, endometrial thickness ≥5mm and intrauterine hyperechoic occupying had a higher AUC value than that of single detection (Z=4.497, 2.281, 2.116, 2.168, 2.679, P＜0.05). Conclusion Postoperative breast cancer patients receiving TAM have a relatively high incidence of endometrial lesions. The main risk factors are the dose of TAM 40mg/d, duration of TAM ≥24 months, AUB/PMB, endometrial thickness ≥5mm and hyperechoic intrauterine occupation. These indices warrant strengthened targeted interventions to prevent endometrial lesions.

  Key words: Postoperative breast cancer; Tamoxifen; Endometrial lesions; Risk factor

  提交时间：2025-12-29

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• 序号	提交日期	编号	操作
  1	2025-12-14	10.12201/bmr.202512.00077V1	下载

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