天津医药

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间质性膀胱炎肥大细胞雌激素受体的表达及意义

王旭1,张卫2,韩瑞发3   

  1. 1. 天津医科大学第二医院泌尿外科研究所 杨雄
    2. 天津医大二院泌尿外科
    3. 天津市泌尿外科研究所
  • 收稿日期:2010-08-11 修回日期:2010-12-04 出版日期:2011-07-15 发布日期:2011-07-15
  • 通讯作者: 王旭

Bladder Mast Cell Expression of Estrogen Receptors in Patients with Interstitial Cystitis

xu wang,ZHANG wei ,   

  • Received:2010-08-11 Revised:2010-12-04 Published:2011-07-15 Online:2011-07-15
  • Contact: xu wang

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摘要： 【摘要】　目的　检测雌激素受体在间质性膀胱炎（IC）患者膀胱黏膜肥大细胞上的表达情况，探讨雌激素通过调控肥大细胞的激活在间质性膀胱炎发病机制中的作用及其临床意义。 方法　间质性膀胱炎患者膀胱黏膜活检组织标本18例，12例正常膀胱黏膜活检组织标本作为对照组。分别采用0.5%甲苯胺蓝及抗人肥大细胞类胰酶抗体标识组织标本肥大细胞；多克隆抗人雌激素受体抗体标识标本膀胱黏膜上雌激素受体；统计学分析2组标本在肥大细胞数目、脱颗粒肥大细胞比例及雌激素受体表达方面的差异。 结果　IC组织标本中肥大细胞密度（5.59±3.40）个/HP，明显高于对照组（2.48±2.23）个/HP，差异有统计学意义（ t=2.787, P<0.01）；IC组织中75.3％的肥大细胞呈不同程度脱颗粒状态，对照组未见明显脱颗粒肥大细胞存在； IC组织标本中ER+细胞（3.77±3.03）个/HP，对照组ER+细胞（0.88±0.76）个/HP，两组比较差异有统计学意义（t=3.870 P<0.01）；肥大细胞与雌激素受体阳性(ER+)细胞显著相关,相关系数为0.884(P<0.01)。 结论　IC患者组只有肥大细胞出现雌激素受体的过表达，肥大细胞为雌激素在IC患者膀胱黏膜上的重要靶点；这一结果揭示雌激素可能通过其在肥大细胞上的受体表达来调控肥大细胞脱颗粒，产生间质性膀胱炎特有的临床症状。同时也解释了IC高发于中年女性的原因。

关键词: 间质性膀胱炎, 肥大细胞, 雌激素受体

Abstract: 【Abstract】 Objectives To investigate the role of estrogen and the mast cells in the pathogenesis of the interstitial cystitis patients,specifically with respect to activated bladder mast cells. Methods 18 cystoscopy biopsy specimens from patients with interstitial cystitis and 12 control subjects were analyzed blindly for the numbers of mast cells and the presence of estrogen receptors(ER). Immunohistochemical methods were used to detect ER and MC．And double immunohistochemical staining was used to manifest the expression of ER in interstitial cystitis MC． Results Bladder MC alone were shown to express high affinity ER，ER+cells in IC (3.77±3.03/HP) comparing with controls（0.88±0.76/HP）(t=3.870,P<0.01) and there was a higher number of MC present in patients with IC（5.59±3.40/HP）compared with controls（2.48±2.23/HP） (t=2.787,P<0.01).The unique finding that only MC express ER(R=0.884，P<0. 01),in spite of the inflammatory infiltrate present. Conclusions MC high affinity estrogen receptors may help to explain why interstitial cystitis occurs primarily in women,why IC and other associated symptoms tend to be worst at the midcycle. These results have shown that estrogen augment MC histamine secretion, which have a high prevalence in women such as IC.

Key words: Interstitial Cystitis, Mast Cell, Estrogen Receptor