Research On The Effects Of Hormone Replacement Therapy On Cervical Squamous Carcinoma Postoperative Patients’ Quality Of Life And The Safety Of HRT

Objective: Cervical cancer is one of the common gynecologic malignanttumors, serious harm to the health of the women. In recent years, thepathogenesis of cervical cancer shows the trend of the young, after thesepatients undergoing comprehensive treatment (surgery and/or chemotherapy),the ovarian function caused serious damage, appear ovarian premature failure(POF), and then show obvious menopausal syndrome and the body whichcause a series of changes, such as the change of the blood, bone loss, heartcerebrovascular disease incidence rate rise, sexual dysfunction, whichseriously affected the patients’ quality of life after cancer cure. HormoneReplacement Therapy (HRT) is a kind of effective method, that is addappropriate amount of hormones to relieve patients’ menopausal symptoms,and to improve the level of hormone to reduce the above problems. However,doctors and patients pay attention to the effect of HRT, at the same time,worry more about the use of HRT will promote cancer metastasis andrecurrence. Squamous cell carcinoma antigen (SCC-Ag) is specific maker ofcervical squamous carcinoma, widely used in the disease condition assessment,curative effect and recurrence monitoring, etc. Matrix metalloproteinase(MMP) can degradation cell basement membrane and extracellular matrix, itis a kind of proteolytic enzymes that most closely related with the invasionand metastasis of tumor. MMP-9is the important kind of subtype in the family.This study aims to study the effect of HRT on cervical squamous carcinomapostoperative patients’ quality of life, serum SCC-Ag and matrixmetalloproteinase-9. Then discusses the necessity and safety of the cervicalcancer postoperative patients received HRT.Method:54cases of cervical squamous carcinoma patients were selected from The Fourth Hospital of Hebei Medical University during October2010to August2012. They underwent surgery with resection of bilateral ovariesand after the surgery all appeared menopausal symptoms.33cases as theobjects were given single estrogen addition; blank control group (n=21), donot accept hormone added. With ELISA method, detect the content of patients’serum MMP-9before and after addition6months, then with CMIA method,detect the content of patients’ serum SCC-Ag before and after addition6months, to observe the influences of single estrogen addition on serumSCC-Ag and MMP-9. With radioimmunoassay for the detection of patientsblood follicle-stimulating hormone (FSH), luteinizing hormone (LH),estradiol (E2) content and by the biochemical instrument for the detection ofpatients serum total cholesterol (TC), high density lipoprotein (HDL), lowdensity lipoprotein (LDL), to evaluate the influence of single estrogenaddition on the sex hormone levels and the blood lipid levels. Use theimproved Kupperman scoring method to evaluate the improvement ofmenopausal symptoms.Statistical analysis was finished by the SPSS13.0. Test for normality. Ifmeet the normality, choose the t-test. If not, choose Mann-Whitney U test.P<0.05was accepted as statistically significant.Results:1The difference of Kupperman score between before and after theadditionBefore addition, the experimental group patients’ kupperman score is20.52±7.60. After addition for6months, the experimental group patients’kupperman score is11.52±5.06.THE score have decreased obviously thanbefore addition. The difference has statistical significance (P<0.05). There areno obvious changes of the control group patients’ kupperman score (P>0.05).2The difference of content of E2, FSH, LH between before and after theadditionBefore addition, the experimental group patients’ content of E2, FSH, LHrespectively is14.29±6.19,61.92±18.40and37.01±7.70. After addition for6 months, the content of E2, FSH, LH respectively is42.65±9.68,36.35±9.49and19.33±5.67. E2has increased significantly than before addition. FSH andLH have decreased obviously than before addition. The differences havestatistical significance (P=0.000).In the control group, E2has slightlydecreased than before, FSH and LH has slightly increased than before. Butthere are no significant statistical differences (P>0.05).3The difference of content of TC, HDL, LDL between before and afterthe additionBefore addition, the experimental group patients’ content of TC, HDL,LDL respectively is4.79±0.92,1.18±0.23and3.47±0.85. After addition for6months, the content of TC, HDL, LDL respectively is4.13±0.55,1.52±0.27and2.84±0.43. HDL has increased significantly than before addition. TC andLDL have decreased obviously than before addition. The differences havestatistical significance (P<0.05).There are no obvious changes of the controlgroup patients’ content of TC, HDL, LDL (P>0.05).4The content of serum SCC-Ag and MMP-9in two groups before andafter addition six monthsBefore addition, the experimental group patients’ content of serumSCC-Ag was0.89±0.35, the control group was0.97±0.32. There is nostatistical difference between the two groups (P>0.05).The experimental grouppatients’ content of serum MMP-9was28.61(4.08-110.71), the control groupwas24.36(5.24-117.55). There is no statistical difference between the twogroups (P>0.05). After addition six months, the experimental group patients’content of serum SCC-Ag was0.91±0.36, the control group was0.88±0.28.There is no statistical difference between the two groups (P>0.05).Theexperimental group patients’ content of serum MMP-9was21.31(3.4295.47),the control group was20.415(4.6687.59). There is no statistical differencebetween the two groups (P>0.05). Results showed that the addition of estrogendid not cause the rise of SCC-Ag and MMP-9. Combined with clinicalexamination and relevant auxiliary examination, there are no relapse cases andabnormal changes of breast in the two groups. Conclusion:1Hormone replacement therapy (single estrogen addition) can effectivelyreduce the level of patients’ FSH and LH, increase the content of E2, hasobvious improvement effect on menopausal syndrome. It is very good toimprove the patients’ quality of life.2Hormone replacement therapy (single estrogen addition) can effectivelyreduce the content of patients’ serum TC and LDL; increase the content ofHDL. Because it can improve the postmenopausal women’s biochemicalindicators, it has a good preventive action on cardiovascular andcerebrovascular disease.3Hormone replacement therapy (single estrogen addition) in the shortterm has no significant role in promoting of the patients postoperativerecurrence and metastasis of cancer.