title: Reciprocal effects of tamoxifen on hormonal cytology in postmenopausal women.
abstract: OBJECTIVE
  To evaluate the estrogenic effect of tamoxifen (TAM) therapy in postmenopausal women.
  
  
  METHODS
  The subjects were 26 postmenopausal women. The maturation index (MI), maturation value (MV) and karyopyknotic index (KPI) were evaluated based on hormonal cytology. Endometrial cytologic examinations and transvaginal ultrasonography were also performed.
  
  
  RESULTS
  Of the 26 patients, 16 had low estrogenic activity from the viewpoint of hormonal cytology before TAM administration. During administration, their mean MV rose significantly, from 25.8 +/- 17.7 to 68.8 +/- 13.2, (mean +/- SD) and their mean KPI rose from 9.0 +/- 8.3 to 47.1 +/- 23.1. In contrast, among the 10 patients with high estrogenic activity, mean MV and KPI decreased from 62.9 +/- 8.4 and 27.2 +/- 16.9 to 58.4 +/- 7.7 and 17.7 +/- 16.1, respectively, with TAM administration. Mean endometrial thickness increased more significantly with TAM administration in the low estrogenic activity group than in the high estrogenic activity group.
  
  
  CONCLUSIONS
  TAM had a reciprocal effect; no additional estrogenic effect was seen in patients with high estrogenic activity. Conversely, an estrogenic effect was seen in those with low estrogenic activity. An individualized gynecologic evaluation based on hormonal cytology is useful in selecting patients who will be more susceptible to TAM-induced endometrial abnormality.
authors.affiliation: Department of Perinatology and Gynecology, Kagawa Medical University, 1750-1 Ikenobe, Miki, Kagawa 761-0793, Japan. ashiota@kms.ac.jp
authors.forename: Atsuko
authors.initials: A
authors.lastname: Shiota
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Igarashi
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kurose
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohno
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Hando
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy; D002467:Cell Nucleus / Q000187:drug effects / Q000473:pathology; D002584:Cervix Uteri / Q000187:drug effects / Q000473:pathology; D003475:Curettage; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D005260:Female; D005836:Genitalia, Female / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012189:Retrospective Studies; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects* / Q000627:therapeutic use; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology
chemical_list: D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen