变性男性的子宫内膜癌和子宫内膜变化:从使用睾酮的日本人身上获得的启示。

IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Journal of Obstetrics and Gynaecology Research Pub Date : 2024-10-01 DOI:10.1111/jog.16099
Mariko Nakahara, Hiroshi Yoshida, Aiko Sakamoto, Takeshi Taguchi, Masaya Uno, Tomoyasu Kato, Mitsuya Ishikawa
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引用次数: 0

摘要

目的:使用睾酮的日本变性男性(TGM)的子宫内膜变化仍未得到阐明。本研究旨在介绍患有子宫内膜癌的变性人的情况,以及对类似病例的文献综述。此外,我们还调查了接受性别确认手术的 TGM 中子宫内膜癌与严重肥胖之间的相关性:在 2020 年 7 月至 2023 年 4 月期间,我们对两组人进行了评估:2 名患有子宫内膜癌的 TGM 和 43 名未患子宫内膜癌但接受了性别确认手术的 TGM。对患有子宫内膜癌的 TGM 进行了文献回顾。对临床数据进行了回顾性收集,并对女性生殖器官进行了组织病理学评估:结果:通过文献检索发现了两名患有子宫内膜癌的 TGM 和另外四名类似病例。这些TGM都有严重肥胖(体重指数[BMI]≥30 kg/m2)和长期使用睾酮,这表明子宫内膜癌可能与这些因素有关。随后,我们对 43 名未患癌症的 TGM 进行了调查。我们发现 30% 的人肥胖(体重指数≥25),只有 3 例重度肥胖(体重指数≥30),而且在未患癌症的 TGM 中,睾酮使用时间与体重指数之间存在显著相关性。组织学检查显示,51%的病例存在局灶性增生性子宫内膜,77%的病例存在多囊卵巢病变:我们的观察结果表明,变性男性严重肥胖、长期使用睾酮与子宫内膜癌之间存在潜在联系。女性生殖道的组织学变化突出表明,即使在接受睾酮治疗的情况下,子宫内膜也经常出现灶性增生。进一步的研究应侧重于更大规模的多机构研究,以证实这些发现,并为日本变性人建立子宫内膜癌筛查机制。
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Endometrial cancer and endometrial changes in transgender men: Insights from Japanese individuals on testosterone

Aim

Endometrial changes in Japanese transgender men (TGM) on testosterone use remain elucidated. This study aims to present TGM with endometrial cancer and insights from a literature review of similar cases. Furthermore, we investigated the correlation between endometrial cancer and severe obesity in TGM who underwent gender-affirming surgery.

Methods

Between July 2020 and April 2023, two groups were assessed: 2 TGM with endometrial cancer and 43 TGM without cancer who underwent gender-affirming surgery. A literature review for TGM with endometrial cancer was conducted. Clinical data were retrospectively collected, and histopathological evaluation of female genital organs was performed.

Results

Two TGM with endometrial cancer and an additional four similar cases were identified through a literature search. These TGM had severe obesity (body mass index [BMI] ≥30 kg/m2) and long-term testosterone use, indicating a possible link between endometrial cancer and these factors. Subsequently, we investigated the 43 TGM without cancer. We revealed 30% with obesity (BMI ≥25), only three cases of severe obesity (BMI ≥30), and a significant correlation between testosterone use duration and BMI in TGM without cancer. Histological examination revealed focal proliferative endometrium in 51% of cases and polycystic ovarian changes in 77%.

Conclusions

Our observations suggest a potential link between severe obesity, prolonged testosterone use, and endometrial cancer in transgender men. Histological changes in the female genital tract highlighted frequent focal proliferative endometrium, even under testosterone therapy. Further research should focus on larger, multi-institutional studies to confirm these findings and establish endometrial cancer screening for Japanese TGM.

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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
376
审稿时长
3-6 weeks
期刊介绍: The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.
期刊最新文献
Letter to "Outstanding performance of ChatGPT on the obstetrics and gynecology board certification examination in Japan: Document and image-based questions analysis". Japan Society of Obstetrics and Gynecology revised diagnostic criteria for polycystic ovary syndrome: JSOG2024 criteria. Causes and clinical characteristics of women with primary amenorrhea and ovarian or gonadal disorders at a quaternary hospital. Exploring potential pathways from oxidative stress to ovarian aging. Primary splenic ectopic pregnancy: A case report and literature review of a rare issue.
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