天津医药

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小剂量米非司酮对子宫腺肌病病灶雌、孕激素受体及微血管变化的影响

周毅1,章汉旺2,韩泽民3   

  1. 1. 天津市东丽区东丽医院
    2. 华中科技大学同济医学院妇产科
    3. 武警医学院附属医院
  • 收稿日期:2009-10-12 修回日期:2010-01-28 出版日期:2010-09-15 发布日期:2010-09-15
  • 通讯作者: 章汉旺

The Study on Effect of Mifepristone on PR、ER Expression and MVC Variation of Adenomyosis

  • Received:2009-10-12 Revised:2010-01-28 Published:2010-09-15 Online:2010-09-15

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摘要： [摘要] 目的 探讨用小剂量米非司酮治疗子宫腺肌病后异位病灶中ER、PR表达、MVC和面积的变化及它们之间的相关性。方法 从术后病理检查确诊的病人中选出58例，其中28人术前按要求服用米非司酮治疗3个月设为A组。30例术前没有服用米非司酮或其他雌、孕激素抑制剂的病例作为对照，设为B组。免疫组织化学的方法检测两组病例的子宫腺肌病异位病灶中ER、PR表达和MVC及面积变化的差异性，并分析其相关性。结果（1）A组28例子宫腺肌病异位病灶标本的病灶中，ER的阳性表达21例，阳性率75%；B组30例中ER的阳性表达有26例，阳性率86.67%。PR的阳性表达在A组中22例，阳性率78.57%；B组中PR的阳性表达29例，阳性率96.67%。（2）微血管计数：A组（5个200倍视野）为75.1±7.8个，低于对照组B组90.4±8.7个，微血管面积：A组为783.3±54.2，B组为2334±129.4。 结论 小剂量米非司酮可以抑制性调节子宫腺肌病异位病灶中ER、PR的表达；并可能通过降低ER、PR的表达抑制病灶中血管的形成和减小血管的管径，从而减少病灶内的血液供应，发挥治疗子宫腺肌病的作用。

关键词: 子宫腺肌病, 米非司酮, 雌激素受体, 孕激素受体, 微血管计数

Abstract: [Abstract] Objective To investigate variation and correlation of estrogen receptor(ER), progestin receptor (PR) and micro vessel count (MVC) in adenomyosis sites after treatment by small dose mifepristone. Method Experimental group (A) included 28 cases with adenomyosis classified manifestation and ultrasound diagnosis and identifyied by post operation histological section diagnosis receipted mifepristone 12.5mg/d for three months. The control group(B) had 30 patients without any ovarian hormone drug treatment. All specimen was treated by same method. ER, PR and MVC in the two groups were detected by immunohistochemical assay, and analyze the relation among them. Result There were 21（75%） positive cases and 26（86.67%） cases of ER protein in group A and group B respectively，there were difference between group A and group B in ER expression（P＜0.05)．There were 22（78.57%） positive cases and 29（96.67%） cases of PR protein in group A and group B respectively，there were obvious difference between group A and group B in PR expression.( P＜0.005).Micro vessel count of group A(75.1±7.8,total of 5 scopes 200 ×) were less than that of group B (90.4±8.7, total of 5 scopes 200 × ), (P＜0.05);the average area of micro vessel of group B(2334±129.4, total of 5 scopes 200 ×) was more than that of group A (783.3±54.2, total of 5 scopes 200 ×), there were obvious difference, (P＜0.001).Conclusion Small dose mifepristone could regular ER,PR expression negative in　adenomyosis．Mifepristone may play role in treating adenomyosis by inhibiting angiogenesis and reducing micro vessel area．.

Key words: KeywordAdenomyosis, Mifepristone, Estrogenreceptor, Progestinreceptor, Micro vessel count