米非司酮对子宫肌瘤细胞凋亡及雌孕激素受体的影响

目的 探讨米非司酮对子宫肌瘤细胞凋亡和雌孕激素受体（ＥＲ，ＰＲ）的影响以及凋亡与受体的关系。方法 １２例子宫肌瘤患者，于月经周期第１５￣１６天口服米非司酮２５ｍｇ／ｄ，连服７ｄ后行子宫切除术，取瘤体和子宫肌组织、行流式细胞术结合形态学变化检测瘤细胞凋亡；做免疫组化观察ＥＲ、ＰＲ变化，９例分泌期手术的肌瘤患者做对照组，同时取增生期１０例、分泌晚期８例、月经期５例以排除激素变化对瘤细胞凋亡及受体的影响

Uterine leiomyomata cell apoptosis and estrogen and progesterone receptors in response to mifepristone

Objective To explore the apoptosis of the uterine Ieiomyomata cell and estrogen and progesterone receptors in response to mifepristone administration as well as the correlation between the apoptosis and the contents of both ER and PR.Methods 12 patients with uterine leiomyomata were treated with 25 mg mifepristone daily beginning on the early secretory phase of the menstrual cycle for a period of seven days.Leiomyomata and myometrial were obtained immediately after the removal of the uterus and divided into two fractions.One was examined by Cytometry for cell apoptosis and the expression of bcl 2/bax gene;the other was determined ER and PR levels and scored semiquantmiquantitatively by immunochemical method.All samples were compared with those of mifepristone unusers who underwent abdominal hysterectomy at the same phase and other phase of the menstrual cycle.Results The cell apoptosis index and the expression of bax gene in the uterine leiomyomata were significantly increased compared with that of control(P<0.01),the SPF and the PR level were significantly lower than that of control(P<0.01),but the expression of the bcl 2 gene was not changed after the treatment(P>0.05).Conclusion It is demonstrated for the first time that mifepristone may induce cell apoptosis through increasing the expression of bax gene protein and decreasing the content of the PR,which may be one of the mechanisms to reduce the uterine leiomyomata.