@article{oai:kagawa-puhs.repo.nii.ac.jp:00000345, author = {塩田, 敦子 and Shiota, Atsuko and 多田, 達史 and Tada, Satoshi and 武部, 晃司 and 新井, 貴士 and 安毛, 直美 and 兼近, 典子 and Takebe, Koji and Arai, Takashi and Yasumo, Naomi and kanechika, Noriko}, journal = {香川県立保健医療大学雑誌, Journal of Kagawa Prefectural University of Health Sciences}, month = {Mar}, note = {application/pdf, TAMによる卵巣過剰刺激作用はかねてより問題となっているが,性腺系への作用,経時的変化の実態は明らかになっていない.初発の乳がん患者において術前から術後TAM内服22か月までのホルモン値を測定し,高エストロゲン血症の発症頻度を含む経時的変化を明らかにした.乳腺外科クリニックにて,同意の得られた閉経前ホルモン感受性陽性乳がん患者に対し,術前から術後(4,10,16,22か月)の定期フォロー時エストラジオール(E2),性腺刺激ホルモン(LH,FSH)を測定した.20例の平均年齢は44.9±2.81(40-50)歳であった.術前の月経は19例で順調であり,LH高値のPCOを疑わせる月経不順の1例のみ術前高E2(>400pg/ml)を示した.術後の総測定回数は78回で,そのうち18回(12例)で高E2がみられた.3か月間無月経でも異常高値をみるものが2例あった.今回の検討症例は40代の症例がほとんどであったにもかかわらず,高エストロゲン血症の発生頻度が今まで報告されてきたより多く,患者の年齢により高エストロゲン血症の発症頻度がかわることはなかった.年齢は少なくとも独立した因子ではなく,卵巣の予備能や環境因子の影響が大きいと考える.予想以上に多くの症例でE2は高値を示すことがわかったが,持続して高値を示すことは多くないこともわかった.内膜への影響の報告もあり,TAM治療の際には乳腺外科と婦人科の連携が必須である.  Adjuvant hormone therapy for hormone-sensitive breast cancer has established the efficacy of tamoxifen (TAM). TAM is widely used in premenopausal patients. In the present study, hormone levels were measured beginning preoperatively to 22 months after oral administration of TAM in patients with first-episode breast cancer. Changes over time, including the frequency of hyperestrogenism, were evaluated. With patient consent, estradiol (E2) and gonadotropin (luteinizing hormone [LH], follicle-stimulating hormone [FSH]) levels were measured at regular follow-up at 4, 10, 16, and 22 months in premenopausal, hormone-sensitive, positive breast cancer patients treated at a Breast Surgery Clinic. The mean age of 20 patients was 44.9 ± 2.81 (40-50) years. Preoperative menstruation was regular in 19 patients. Only one patient with high LH and suspected polycystic ovary syndrome had high preoperative E2 (>400 pg/mL). The total number of postoperative measurements was 72. Of these, 18 (12 cases) showed high E2. There were two cases in which abnormally high values were observed even after amenorrhea for 3 months. Most of the patients in this study were in their 40s. However, the frequency of hyperestrogenism was higher than previously reported, and the frequency of hyperestrogenism did not change with patient age. Age was at least not an independent factor. However, ovarian reserve and environmental factors are believed to have significant impacts. E2 was high in more cases than expected, but was not often persistently high. Effects on the endometrium have been reported, and breast surgery and gynecological cooperation are essential for TAM treatment.}, pages = {39--44}, title = {閉経前乳がん患者におけるタモキシフェン(TAM)内服によるエストラジオール(E2)、卵胞刺激ホルモン(FSH)の経時的変化-約2年間にわたる20例の検討から-}, volume = {13}, year = {2022}, yomi = {シオタ, アツコ and タダ, サトシ and タケベ, コウジ and アライ, タカシ and ヤスモ, ナオミ and カネチカ, ノリコ} }