子宫内膜癌中p53基因第6,第7外显子突变及其临床意义

目的 检测人子宫内膜癌中抑癌基因ｐ５３基因突变的情况并探讨其与病理特征的关系。方法 采用聚合酶链反应（ＰＣＲ）和限制性酶切片段长度多态性分析（ＲＦＬＰ）技术检测４０例子宫内膜癌中ｐ５３基因第６、第７外显子的突变。结果 检出突变例,突变与病理学分级有关,与临床分期、绝经情况、组织学类型无关。结论 ｐ５３基因突变可能是了宫骨膜癌性的原因之一。     

分段诊刮术对子宫内膜癌宫颈受累的诊断意义

（１）目的 探讨分段诊刮术对子宫内膜癌宫颈受累的诊断意义。（２）方法 回顾分析我院１９８０～１９９５年间住院行子宫切除的子宫内膜癌病人６３例,对每个病人的术前分段诊刮和手术病理诊断结果进行比较。（３）结果 分段诊刮术对子宫内膜癌宫颈受累诊断的敏感性为８５．７％,特异性为７２．７％,其阴性预测值为９７．６％,而阳性预测值只有３１．８％。（４）结论 分段诊刮术对子宫内膜癌宫颈受累的阴性诊断结果较阳性诊     

绝经后阴道出血242例临床及病理分析

目的 探讨绝经后阴道出血的病因。方法 分析２４２例绝经后阴道出血并行诊断性乔宫的临床和病理资料。结果 绝经后阴道出血的主要病理诊断分另是功能性子宫内膜（６０．７３％）、炎症（２８．９２％）和恶性肿瘤（１０．３５％）。结论 内分泌紊乱性疾病是绝经后出血的常见病因,年老妇女恶性肿瘤发生率高。     

基因p16及Cyclin D1在子宫内膜癌中的表达及意义

探讨抑癌基因Ｐ１６及细胞周期素Ｄ（ＣｙｃｌｉｎＤ１）在子宫内膜癌,交界性子宫内膜组织及正常子宫内膜组织中的表达规律及其与子宫内膜癌的关系。方法应用免疫组化ＳＡＢＣ法检测３８例子宫内膜癌,１９例子宫内膜增生过长及不典型增长,１０例正常子宫内膜组织中基因ｐ１６,ＣｙｃｌｉｎＤ１的表达。     

Regression of endometrial hyperplasia after treatment with the gonadotrophin-releasing hormone analogue triptorelin: a prospective study

Endometrial hyperplasia is thought to be caused by the prolonged, unopposed oestrogenic stimulation of the endometrium. The regression of hyperplastic back to normal endometrium is the main purpose of any conservative treatment in order to prevent development of adenocarcinoma. The aim of this study was to evaluate the regression of hyperplastic to normal endometrium in patients with various forms of endometrial hyperplasia after treatment with the gonadotrophin-releasing hormone analogue (GnRHa) triptorelin for 6 months. Fifty-six patients with endometrial hyperplasia were enrolled in this trial; 39 patients (group I) presented simple hyperplasia, 14 (group II) complex hyperplasia and three (group III) atypical complex hyperplasia. All patients were treated with triptorelin for 6 months. Bleeding control during treatment was excellent. A post-treatment curettage for estimation of endometrial histology was performed on 54 out of 56 patients 100.1 +/- 44.7 days after the last triptorelin dose, following the restoration of pituitary function. Regression of hyperplastic to normal endometrium was observed in 32 (86.5%) out of 37 patients in group I and in 12 (85.7%) out of 14 in group II. Persistence of simple hyperplasia was found in five (14.5%) out of 37 patients in group I. Persistence of complex hyperplasia was found in 1 (7.1%) out of 14 patients and progression to atypical complex hyperplasia in another one (7.1%) woman in group II. In some of these cases, the presence of risk factors such as obesity, diabetes mellitus and ovulatory disturbances may contribute to the disease persistence despite therapy. On the other hand, in group III, none of the three patients had normal post-treatment endometrial histology. It seems, therefore, that in cases of endometrial hyperplasia without atypia, the administration of the GnRHa triptorelin is associated with high regression rates to normal endometrium. Conversely, the presence of atypia seems to be a poor prognostic factor. Treatment tolerance and bleeding control during therapy is excellent.     

Endometrial pinopodes indicate a shift in the window of receptivity in IVF cycles

The formation of endometrial pinopodes detected by scanning electron microscopy may be a specific marker for uterine receptivity. Aiming to assess the effects of ovarian stimulation on pinopode formation, we examined sequential endometrial biopsies from 17 oocyte donors. Seven normally menstruating women served as controls. Up to four samples were taken from each woman at 24-72 h intervals between days 14 and 24, giving a total of 69 samples. The day of oocyte retrieval was designated day 14 in ovarian stimulation cycles and the day of luteinizing hormone surge was designated day 13 in natural cycles. Endometrial morphology and pinopode numbers were similar in both groups. Fully developed pinopodes appeared in only one sample per cycle, indicating their short life span. However, the cycle day these structures appeared varied up to 5 days between women and the distribution was as follows: day 18 (n = 2), day 19 (n = 7), day 20 (n = 4), day 21 (n = 3), day 22 (n = 1) in ovarian stimulation cycles, and day 20 (n = 2), day 21 (n = 2), day 22 (n = 3) in natural cycles. Furthermore, accelerated pinopode formation in ovarian stimulation cycles was positively correlated with day 13 progesterone. Our findings show that ovarian stimulation does not affect endometrial pinopode formation in terms of quantity and life span. The cycle days when pinopodes form are specific to the individual, being on average 1-2 days earlier in ovarian stimulation than in natural cycles. These changes in pinopode expression may reflect shifts in the window of receptivity, resulting in ovo-endometrial asynchrony and limiting implantation success in in-vitro fertilization.     

Anordrin对人体子宫内膜超微结构的影响

本文报道了口服Anordrin一个周期的妇女子宫内膜腺体细胞和基质细胞超微结构的变化。结果指出,服药2—3天后两类细胞的线粒体都发生肿胀,这可能是抑制腺体细胞发育和基质细胞转化的重要原因。溶酶体的提早出现又表明Anordrin 有促使子宫内膜早衰的作用,这可能与黄体功能不足有关,另从Anordrin 对离体培养子宫内膜的作用看,也不能排除Anordrin 对细胞有直接作用。     

子宫内膜癌中nm23和c-erbB-2蛋白的表达及其意义

目的　研究nm2 3和c -erbB - 2蛋白在子宫内膜癌中的表达及其临床意义。方法　用LSAB免疫组化法检测 4 2例子宫内膜癌中nm2 3和c -erbB - 2蛋白的表达。结果　nm2 3和c -erbB - 2在子宫内膜癌中的阳性表达率分别为 6 0 0 %、 4 7 6 % ,其阳性表达与年龄、不同组织学类型差异无显著 (P >0 0 5 ) ;nm2 3与病理分级呈负相关 (P <0 0 1 ) ,无淋巴结转移者阳性表达率明显高于淋巴结转移者 (71 9%和 2 0 0 % ,P <0 0 5 ) ;c -erbB - 2的表达与癌细胞的分化程度、临床分期有关 ,分化程度高及早期癌中c -erbB - 2表达强。结论　对子宫内膜癌组织进行nm2 3和c -erbB - 2蛋白的检测 ,有助于了解子宫内膜癌的临床病理特征和预后     

雌激素受体亚型mRNA在子宫内膜癌组织中的表达

目的比较雌激素受体两种亚型α和β在子宫内膜癌中的表达,探讨雌激素受体亚型在子宫内膜癌发生和发展中的作用.方法用RT - PCR法检测子宫内膜癌和正常子宫内膜组织雌激素受体mRNA的表达.结果①与正常子宫内膜组织比较,子宫内膜癌中ER α mRNA、ER β mRNA表达和ER β/ER α mRNA比值都明显上升;②早期、内膜样子宫内膜癌ER α mRNA明显上升.结论子宫内膜癌的发生与ER α和ER β的表达有关,ER α mRNA表达升高可能提示子宫内膜癌预后较好.     

血清CA125检测在子宫内膜癌中的价值

目的探讨血清CA125在子宫内膜癌中的价值.方法选取1992年3月～2002年3月在北京大学第一附属医院、北京大学人民医院住院经手术治疗的子宫内膜癌患者141例,术前及随访中用放射免疫法测定血清CA125水平,CA125≥35 U/ml 为阳性结果.对其中14例行子宫内膜癌组织CA125免疫组化方法检测.收集患者的临床病理资料,分析CA125与这些资料的关系以及复发患者复发前后CA125变化.结果 CA125免疫组化检测14例均呈阳性,阳性细胞着色率与血清CA125之间无明显相关.141例患者术前血清CA125阳性32例(22.7%), Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者血清CA125阳性(阳性率)分别为11例(12.1%)、6例(31.6%)、12例(46.2%)和3例(60.0%). 血清CA125阳性率随子宫内膜癌期别的增加而升高.深肌层浸润、宫颈受累、附件转移、腹腔洗液细胞学阳性、盆腔淋巴结转移及宫内肿瘤病灶≥2 cm者,血清CA125阳性率增加.随访中13例复发,其中9例术前血清CA125＞35 U/ml者复发时均伴血清CA125水平升高,而另4例术前血清CA125正常者,复发后血清CA125水平仍正常.结论子宫内膜癌患者术前血清CA125的测量有助于了解肿瘤的侵犯范围.术前血清CA125水平异常的子宫内膜癌患者,术后定期复查血清CA125水平,将有助于子宫内膜癌病情的监测.