若年体癌・異型増殖症患者297例に妊孕性温存療法では、病変消失率は異型増殖症131例：98.5%、類内膜癌G1例160例：91.9%、G2例6例：100%であったが、子宮内再発率はそれぞれ55%、83%、75%であった。妊娠は87名、延べ138回で103名の生児を得た (妊娠率は45%)。35-39歳台までは35-75%の妊娠率を示し たが、40歳代以降では体癌例で5%に低下した。反復治療でも良好な病変消失率と妊娠率が得られた。多嚢胞性卵巣、月経不整周期、hMLH1蛋白発現低下などが再発上昇と関連していた。制御性T細胞と、分化度、MSI、黄体ホルモン感受性との関連についてはデータ解析中である。
We performed fertility-preserving MPA therapy for young patients with endometrial cancer (EC) and atypical endometrial hyperplasia (AEH). Tumor disappeared in 98.5% in 131 AEH cases, 91.9% in 160 G1 EC cases, 100% in 6 G2 EC cases. Tumor relapsed in uterine cavity in 55%, 83%, 75%, respectively. Pregnancy was obtained in 87 cases. In total, 138 times pregnancies and 103 live-birth children were obtained, and the pregnancy rate was 45%. The pregnancy rates by age and pathological types were 35 to 75% under 40 years in both AEHC and EC patients, however, EC patients in age 40 or more showed 5% pregnancy rate. Repeated MPA therapy after recurrence showed high tumor disappearance rate and pregnancy rate as well as after initial MPA therapy. The clinicopathological factors such as polycystic ovary, irregular menstrual cycle, low expression of hMLH1 were associated with elevated recurrence rate. The data regarding regulatory T cells and sensitivity for progesterone are now in analysis.

研究種目 : 基盤研究(C)(一般)
研究期間 : 2016～2018
課題番号 : 16K11156
研究分野 : 婦人科腫瘍学