| Background: Cervical cancer is one of the most common malignancies.In recent years,the prevalence of the cervical carcinoma tends to be younger.For young patients with early cervical cancer,the now main treatment modalities was radical resection operation combined with comprehensive treatment of radiotherapy and chemotherapy by postoperative pathology.However,the traditional cervical cancer radical resection of bilateral ovarian and chemotherapy can affect endocrine function.The ovary is an important endocrine and reproductive organ of female,which plays an important role in maintaining metabolism,endocrine,physiological and reproductive function of female.If loss of ovarian function,hormone levels in body will drop.In addition to occurrence of menopause syndrome,there will be a night sweats,vaginal atrophy,decreased libido,sexual pain,irritability,anxiety and other mental,neurological symptoms.It also contributed to the occurrence or aggravation of some diseases,such as hypertension,coronary heart disease and osteoporosis.And seriously affect the physical and mental health.Therefore,it is very important to preserve the ovary in premenopausal women.The ovary is extremely sensitive to radiation and dose dependent,but the ovaries far away from the radiation field are hardly affected by radiation.Therefore,how to preserve the ovarian function and improve the quality of life of patients is a common concern of doctors and patients.Objective: The purpose of this study was to investigate the changes of ovary function on ovary transposition in patients with early carcinoma and the effect to transposed ovarian function in patients with early carcinoma with radical therapy.Methods: Retrospective analysis the clinical data of ovarian transposition patients with stage IA~II A cervical cancer before postmenopausal in the second affiliated hospital of Dalian Medical University from December 2002 to January 2016.The patients without adjuvant radiotherapy was control group(n=24)and adjuvant radiotherapy patients was study group(n=16).In follow-up of patients after radiotherapy and surgery whether had perimenopausal symptoms and the serum level of FSH,E2 and LH determined by chemiluminescence immunoassay to determine the ovarian endocrine function and investigate the status of sexual life.In the first year afer operation,to monitor,compared and statistics analyze level of FSH,E2 and LH of study group and control group.The statistical analysis was performed by SPSS 13.0 software and measurement data were tested by independent sample t test and enumeration data were examined by X2 test.The difference was statistically significant with P<0.05.Results:(1)Perimenopausal symptom survey: study group(25 percent)appeared perimenopausal symptoms,main symptoms of hot flashes,night sweats,irritability,insomnia and accompanied by vaginal dryness,less discharge and sexual difficulties etc.The rest 12 patients had no perimenopausal symptoms and their vaginal mucosa was soft,moist,flexible,vaginal secretions was normal examined by gynecologic examination.The patients in the control group were no perimenopausal symptoms and serum FSH,E2,LH values were normal.We found that patients in the study group(75percent)were reserved for ovarian function,then control group all patients retained the ovarian function.(2)Sexual life survey: In the one years after operation,all the patients had sexual life and 34 patients were satisfied with sexual life.In the one years after operation,all the patients had sexual life and the sexual life of control group were basically satisfied;then study group which 10 cases were satisfied with sexual life and 6cases were not.(3)The results showed that the treatment group was mostly treated with VMAT,and the average dose of ovarian treatment was 600 c GY.(4)In the first year after operation,to monitor level of FSH?E2?and LH of study group and control group.Compared with the patients without radiotherapy,postoperative radiotherapy increased expression of FSH and LH in the serum of patients with cervical carcinoma,but decreased expression of E2.To compared control group(no radiotherapy group)with study group(radiotherapy group),P<0.05,there is statistics significance.Conclusion: The cervical cancer patients with ovarian transposition can still retain the function of the ovarian.Although adjuvant radiotherapy has an impact on ovarian function after ovarian transposition.But for cervical cancer patients who need postoperative adjuvant radiotherapy,ovarian transposition can still be part of preserving ovarian function.In general,ovarian transposition to a certain extent could avoid the radiation-induced damage,improved the patient's menopause symptoms and the quality of life of patients who need postoperative adjuvant radiation therapy. |
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