关键词: 高分化子宫内膜癌, 非典型子宫内膜增生, 醋酸甲羟孕酮, 保守治疗, 妊娠结局

Abstract: Objective To identify factors that might affect establishing pregnancy following conservative treatment by medroxyprogesterone acetate(MPA)for well-differentiated endometrioid adenocarcinoma(EC)or atypical endometrial hyperplasia(AEH).Methods A retrospective study of 65 patients with EC/AEH were divided into a pregnancy group(n=34)and a non-pregnancy group(n=31).The influent factors on establishing pregnancy were detected by statistical analysis.Results There was no significant difference in clinical characteristics between pregnancy group and non-pregnancy group.There were significantly different between pregnancy group and non-pregnancy in the duration of MPA administration,the time to disappearance of lesions,the age of pregnancy permission,the number of D&C procedures performed,and endometrial thickness during ovulation(P＜0.05).The multivariate logistic regression analysis identified that the recurrence(OR=2.323,P=0.015),endometrial thickness during ovulation(OR=0.283,P＜0.001),and age of pregnancy permission(OR=2.524,P=0.039)were significant factors affecting pregnancy outcomes.Conclusion Recurrence,endometrial thickness during ovulation,and the age of the pregnancy permission were considered to affect pregnant establishment following conservative treatment with MPA.Assisted reproductive technology immediately after achieving tumor disappearance by MPA would therefore be beneficial for patients with disease recurrence,thin endometrium,or a higher age of pregnancy permission.

Key words: Well-differentiated endometrioid adenocarcinoma, Atypical endometrial hyperplasia, Medroxyprogesterone acetate, Conservative treatment, Pregnant outcomes