Abnormal expression of estrogen receptor is associated with thin endometrium

Abstract

This study was conducted to investigate the association of estrogen receptor (ER) and progesterone receptor (PR) expressions with thin endometrium. Patients with endometrial thickness of less than 7?mm were classified as the study group, while the control group was comprised of patients with endometrial thickness of 7 to 14?mm. The expressions of ER and PR were detected with semi-quantitative immunohistochemical analysis, and the differences were compared between the two groups. The expression of ER was significantly decreased (p?<?.05) in the stromal cells of thin endometrium during both proliferative and secretory phases as compared to those of normal endometrium. Likewise, ER expression was found to be lower in the glandular cells of thin endometrium than those of normal endometrium during proliferative phase. However, no significant differences were observed for the expression of PR in both glandular and stromal cells between the two groups. Thin endometrium was associated with reduced expression of ER in stromal cells both during proliferative and secretory phase, but in glandular epithelial cells only during proliferative phase.     

Expression of steroid receptors, Ki-67, and epidermal growth factor receptor in tamoxifen-treated endometrium.

Endometrial specimens of 34 (25 premenopausal and 9 postmenopausal) breast cancer patients receiving tamoxifen were immunohistochemically examined using estrogen receptor (ER), progesterone receptor (PR), Ki-67, and epidermal growth factor receptor (EGFR) antibodies. Proliferative (n = 6), secretory (n = 9), and postmenopausal (n = 6) endometria served as controls. The ER and PR expressions of the glandular cells in tamoxifen-treated patients did not differ from those of the glandular cells in the control women regardless of menopausal status. The Ki-67 index of glandular cells in tamoxifen-induced amenorrheic women was found to be lower than that of the proliferative glandular cells in the control women (p < 0.03), whereas the Ki-67 index of glandular cells in the tamoxifen-treated postmenopausal patients was higher than that of the glandular cells in the control women (p < 0.02). No EGFR overexpression was found in the glandular cells of the tamoxifen-treated premenopausal patients, but expression of EGFR was high in glandular cells of the tamoxifen-treated postmenopausal patients associated with a high Ki-67 index. In competition with ovarian estrogen secretion, tamoxifen may have an antiestrogenic effect on the endometrium, but tamoxifen probably has an estrogenic effect in the absence of ovarian estrogen secretion. This estrogenic effect of tamoxifen may be associated with an EGFR autocrine system.     

Molecular markers in the endometrium at baseline of postmenopausal patients with early breast cancer in the ATAC (Arimidex, tamoxifen, alone, or in combination) trial

OBJECTIVE: This study was undertaken to assess baseline endometrial molecular events in the ATAC (Arimidex, tamoxifen, alone, or in combination) trial of breast cancer adjuvant therapy. STUDY DESIGN: Estrogen receptor (ER) and progesterone receptor (PR) levels and markers of cell proliferation (Ki67) and apoptosis ( Bcl -2) were assessed in 93 patients at baseline. RESULTS: An inactive/atrophic endometrium was found in 63 patients, 5 had a proliferative endometrium, and 12 had a secretory endometrium. Thirteen endometrial polyps were analyzed. Inactive endometrium showed high levels of ER in the glandular epithelium, whereas in more than 50% of samples, PR expression was negative or low (+) in the glandular epithelium, and stroma. Ki67 expression was low in both the glandular epithelium and the stroma of the inactive endometrium, whereas Bcl -2 expression was mostly high or very high (+++/++++) in the glandular epithelium. Bcl -2 was strongly expressed (+++/++++) in the glandular epithelium of polyps. CONCLUSION: Although all patients were asymptomatic, some had endometrial pathology.     

The role of c-jun protein in proliferation and apoptosis of the endometrium throughout the menstrual cycle

Proliferation and apoptosis of the endometrium throughout the menstrual cycle were evaluated. Sections from 30 premenopausal women were examined using antibodies of c-jun protein, c-fos protein, estrogen receptors alpha and beta (ER-alpha and ER-beta), progesterone receptor (PR), and Ki-67. Apoptotic cells were identified using a modified terminal deoxynucleotidyl-transferase-mediated biotinylated deoxyuridine triphosphate nick-end labeling (TUNEL) method. The cyclic changes of c-jun protein, c-fos protein, ER-alpha, PR, and Ki-67 were shown in glandular epithelial cells. Although the stromal expression of ER-alpha decreased during the secretory phase, a high stromal expression of c-jun protein and PR was still observed during the late secretory phase. The expression of ER-beta appeared lower as compared with that of ER-alpha, without a cyclic change. The apoptotic index was significantly elevated in the glandular epithelial cells of the late secretory phase, whereas a few apoptotic cells were detected in the stromal cells at any stage of the cycle. The cyclic change of c-jun protein probably plays an important role in proliferation and apoptosis of glandular epithelial cells. The persistent stromal expression of c-jun protein and PR is thus considered to prevent stromal cells from entering into apoptosis during the late secretory phase.     

子宫内膜癌分子标志物与临床病理特征关系的研究

目的探讨子宫内膜癌中ER、PR、PTEN、p53及Ki-67的表达与临床、病理特征的关系。方法收集200例原发性子宫内膜癌患者的临床病理资料,对其ER、PR、PTEN、p53及Ki-67表达情况进行统计学分析。结果①子宫内膜癌病例中．ER、PR、PTEN、p53的阳性表达率分别为86．5％、85．5％、82．10和49．2％;Ki-67在癌灶中的阳性表达率为4％--95％,平均为46．9％。②妊娠次数与PR阳性表达呈负相关（r=-0．191,P=0．007）,而发病年龄、分娩次数与p53阳性表达呈正相关（r=0．184,P=0．041;r=0．255,P=0．004）。③子宫内膜样腺癌ER、PR、p53阳性率与其他类型子宫内膜癌比较,差异有统计学意义（P〈0,01）。④ER阳性表达与手术病理分期呈负相关（r=-0．155,P=0．028）,其中I期患者ER阳性率高于Ⅱ期及以上患者（P=0．032）。⑤ER、PR阳性表达与组织学分级呈负相关（r=-0．217,P=0．002;r=-0．317,P=0．000）,但p53、Ki-67表达与其呈正相关（r=0．327,P=0．000;r=0．465,P=0．000）。⑥ER阳性表达与肌层浸润深度呈负相关（r=-0．142,P=0．046）,在有无深肌层浸润上ER、PR表达率均有统计学意义（P〈0．05）。结论对子宫内膜活检组织进行分子标志物的分子特征检测,有助于指导临床。     

芳香化酶蛋白及性激素受体等在子宫内膜病变组织中的表达变化及意义

目的探讨芳香化酶蛋白、雌激素受体（ER）、孕激素受体（PR）及细胞增殖相关核抗原Ki67在子宫内膜病变组织中的阳性表达率及其在子宫内膜病变的诊断和治疗中的价值。方法采用免疫组化链霉菌抗生物素蛋白-过氧化物酶链接（SP）法,检测148例子宫内膜病变患者（观察组,其中子宫内膜增殖症30例,轻、中、重度子宫内膜非典型增生各10例,子宫内膜腺癌88例）及30例因患宫颈原位癌行子宫全切除术患者的正常子宫内膜组织（对照组,其中增殖期及分泌期子宫内膜各15例）中芳香化酶蛋白、ER、PR及Ki67的阳性表达率。结果（1）观察组子宫内膜增殖症、子宫内膜非典型增生组织芳香化酶蛋白、ER、PR、Ki67的阳性表达率与对照组增殖期内膜比较,差异无统计学意义（P〉0．05）;（2）观察组子宫内膜腺癌组织芳香化酶蛋白阳性表达率为64％（56／88）,与子宫内膜非典型增生（23％,7／30）、子宫内膜增殖症（13％,4／30）及对照组（0／15）比较,差异均有统计学意义（P〈0．01）;（3）芳香化酶蛋白的阳性表达率与子宫内膜腺癌的临床分期（Ⅰ期61％、Ⅱ期77％、Ⅲ期70％、Ⅳ期67％）、肿瘤细胞分化级别（高分化64％,中分化74％,低分化58％）、有无淋巴转移（转移59％,无转移67％）无明显相关性（P〉0．05）。（4）子宫内膜腺癌组织中ER、PR、Ki67的阳性表达率分别为22％（19／88）、19％（17／88）、41％（36／88）,与对照组分别比较,差异均有统计学意义（P〈0．01）。结论子宫内膜良性病变组织与正常内膜组织中,芳香化酶蛋白表达无明显差异;子宫内膜腺癌组织中芳香化酶蛋白的过度表达,可作为诊断子宫内膜腺癌的指标之一。     

Dissociated expression of Bcl-2 and Ki-67 in endometrial lesions: diagnostic and histogenetic implications.

The objective of the present study was to analyze the expression of the proliferation marker, Ki-67, and the anti-apoptotic protein, bcl-2, in various endometrial lesions. Ki-67 and bcl-2 expressions were studied in 194 specimens of endometrial hyperplasia, polyps, carcinomas, and cyclic endometrium from a defined geographic area. Results were statistically analyzed with respect to marker expression, localization to the stromal or glandular component, and intraglandular topography. The lowest glandular Ki-67 expression was seen in secretory endometrium, in polyps, and in atypical hyperplasia. The Ki-67 score was significantly higher and less heterogeneous in endometrial carcinomas than in hyperplasia (p<0.001). Endometrial hyperplasia of all types was characterized by a markedly heterogeneous glandular expression of Ki-67. The glandular expression of bcl-2 was highest in proliferative endometrium and polyps. Bcl-2 expression was significantly lower in adenocarcinomas than in hyperplastic lesions (p=0.002). Ki-67 and bcl-2 expression showed a significant association in proliferative endometrium (p=0.003). Endometrial polyps demonstrated a unique pattern of very low expression of Ki-67 and high bcl-2 expression in both stroma and glands. Our findings indicate that an imbalance between proliferation and apoptosis may be an important factor in the development of different endometrial lesions, benign as well as malignant. The specific finding of inter- and intraglandular Ki-67 heterogeneity may be valuable as an adjunct to morphology in the differential diagnosis of endometrial hyperplasia.     

雌激素受体、孕激素受体、C-erbB-2和Ki-67在子宫内膜癌中的表达及其与临床病理相关性

目的 探讨雌激素受体（ER）、孕激素受体（PR）、C-erbB-2和Ki-67在不同子宫内膜组织中的表达及其与临床病理的相关性。方法 采用免疫组化S-P法检测2004年1月至2013年1月郑州人民医院病理科存档30例正常子宫内膜、30例不典型增生、80例子宫内膜癌组织中ER、PR、C-erbB-2、Ki-67的表达。结果　ER、PR在正常子宫内膜、不典型增生和子宫内膜癌中表达逐渐降低(P<0.05),在不同分化子宫内膜癌组织类型中表达有差异(P<0.05);C-erbB-2在正常子宫内膜中不表达,在不典型增生中表达为53.33%和子宫内膜癌中表达为80.00%,两两比较差异有统计学意义(P<0.05);Ki-67在正常子宫内膜仅有少量表达,在不典型增生子宫内膜中表达为33.33%和子宫内膜癌中表达为63.75%,差异均有统计学意义(P<0.05)。C-erbB-2及Ki-67的表达与子宫内膜癌的分化程度、临床分期、肌层浸润深度及淋巴结转移4种病理特征均有关(P<0.05)。结论　ER、PR、C-erbB-2和Ki-67表达与子宫内膜癌的临床病理相关,可作为判断子宫内膜癌预后及指导临床治疗的指标。     

hMG对分泌晚期子宫内膜雌、孕激素受体基因表达的影响

目的:研究人绝经期促性腺激素(hMG)促排卵治疗对分泌晚期子宫内膜雌激素受体(ER)、孕激素受体(PR)基因表达的影响。方法:采用原位杂交技术,对9例hMG促排卵周期(实验组)分泌晚期子宫内膜ER、PRmRNA进行测定,并与11例自然周期(对照组)进行对照研究。结果:实验组分泌晚期子宫内膜腺体细胞内ER、PRmRNA水平明显低于对照组(P<0.05和P<0.005)。结论:hMG在转录水平降低分泌晚期子宫内膜腺体细胞ER、PRmRNA的表达。     

Comparative immunohistochemical study of endometrioid and serous papillary carcinoma of endometrium.

OBJECTIVE: The aim of this study was to determine whether immunohistochemical analysis of molecular parameters can provide an alternative method for classification of endometrial cancer cases according to their aggressiveness. METHODS: Sixty-four cases of endometrial carcinoma were assigned to three groups: group I--28 cases of endometrioid well and moderately differentiated (G1-G2) carcinoma; group II--14 cases of endometrioid poorly differentiated (G3) carcinoma; group III--22 cases of serous papillary endometrial cancer. Immunohistochemistry was used to determine the existence of estrogen receptors (ER), progesterone receptors (PR), and the expression of bcl-2, p53, HER-2/neu and Ki-67. RESULTS: There was a significant difference in the immunohistochemical profile of the studied molecular parameters comparing the three study groups. The endometrioid G1-G2 cases (group I) were characterized by increased immunoreactivity for ER and PR (85.7% and 78.6%, respectively), increased immunoreactivity for bcl-2 (42.8%) and low expression of p53 (14.3%) and HER-2/neu (14.3%). In contrast to group I cases, the serous papillary endometrial cancer cases (group III) were characterized by immunonegativity for ER, PR and bcl-2 and high immunoreactivity for p53 (81.8%) and HER-2/neu (45.4%). The endometrioid G3 cases (group II) demonstrated an intermediate immunoprofile, characterized by immunonegativity for ER, PR and HER-2/neu, low immunoreactivity for bcl-2 (7.1%) and high expression of p53 (57.1%). The expression of Ki-67 did not differ significantly comparing the different cases of endometrial cancer. CONCLUSION: This study provides evidence that the immunohistochemical analysis of endometrial carcinoma differentiates between different grades and histological types, thus being useful in the distinction of high risk cases.     

子宫内膜癌雄激素受体表达及临床意义

目的:探讨子宫内膜癌组织中的雄激素受体(AR)的表达及其与临床病理特征和雌激素受体(ER)、孕激素受体(PR)表达的关系。方法:应用免疫组织化学SP法检测41例正常子宫内膜、18例不典型增生及116例子宫内膜癌组织中AR、ER、PR的表达。结果:①子宫内膜细胞普遍存在AR的表达,在正常子宫内膜、不典型增生子宫内膜、子宫内膜癌组织中阳性表达率逐渐增高,但差异无统计学意义(P=0.424)。②AR在子宫内膜癌中的表达随患者FIGO分期、组织病理分级的升高而下降(P=0.011;P=0.047),而与患者发病年龄、是否绝经、组织学类型、淋巴结有无转移、肌层有无浸润无明显关系(P>0.05)。③AR的表达与ER、PR的表达呈正相关(r=0.293,P=0.001;r=0.275,P=0.003)。结论:AR在子宫内膜癌的发生、发展中可能起重要作用,AR阳性表达者的生物学行为较好。     

种植窗期预测体外受精-胚胎移植结局指标的研究

目的 探讨种植窗期子宫内膜雌、孕激素受体（ER、PR）及血管内皮生长因子（VEGF）的表达与体外受精-胚胎移植（IVF—ET）结局的关系，选择能预测IVF—ET结局的良好而可靠的指标。方法 2004-05—2005-01对郑州大学第二附属医院生殖中心40例拟行IVF—ET妇女，在IVF—ET前1周期采用免疫组化SP法和组织学积分H—score方法对ER、PR和VEGF在种植窗期子宫内膜中的表达进行定位和半定量分析。按IVF—ET后是否妊娠将40例不孕患者分为两组：妊娠组和未妊娠组。结果 未妊娠组腔上皮、腺体PR表达较妊娠组强，差异有统计学意义（P〈0．05），间质PR表达较妊娠组弱，差异有统计学意义（P〈0．05）；妊娠组和未妊娠组子宫内膜ER表达差异无统计学意义（P〉0、05）；VEGF在子宫内膜中的表达妊娠组较未妊娠组高，差异有统计学意义（P〈0．05）。结论 种植窗期子宫内膜腔上皮、腺体PR下调失败，间质PR表达减弱及子宫内膜VEGF的表达减弱可导致IVF—ET妊娠失败。种植窗期子宫内膜PR和VEGF的表达可作为预测妊娠是否成功的指标。     

Impact of ovarian stimulation on mid-luteal endometrial tissue and secretion markers of receptivity

The objective of this study was to investigate the effect of ovarian stimulation for IVF on endometrial secretion and tissue markers of receptivity in the mid-luteal phase. In 10 oocyte donors, endometrial secretions and biopsies were sampled 5 days after spontaneous ovulation and oocyte retrieval in consecutive cycles. Four subjects received progesterone in the luteal phase of the stimulated cycles. Mid-luteal endometrial maturation in the stimulated cycle was compared with the spontaneous cycle, by histological dating, Ki-67, oestrogen receptor (ER) and progesterone receptor (PR) expression, secretion levels of leukaemia inhibitory factor (LIF), glycodelin A (GdA) and progesterone, and protein profile. No significant differences in histological markers, expression of Ki-67, PR, ER, secretion protein profiles or concentrations of LIF, GdA, or progesterone were observed when comparing natural with stimulated cycles. Progesterone supplementation of stimulated cycles was associated with significantly lower Ki-67 (P = 0.03) and ER (P = 0.04) expression compared with the non-supplemented stimulated cycle. In this pilot study, ovarian stimulation was not demonstrated to alter the studied markers of endometrial maturation in the mid-luteal phase.     

月经周期人子宫内膜腺上皮和基质细胞HOXA11表达的差异

目的:探讨HOXA11在月经周期人子宫内膜腺上皮和基质细胞中的表达规律及其生理意义。方法:免疫组织化学方法观察38例子宫内膜腺上皮和基质细胞HOXA11蛋白质的表达;用细胞分离筛选法,分离出子宫内膜腺上皮细胞和基质细胞,采用半定量RT-PCR和Dot-blot方法分别观察HOXA11在腺上皮和基质细胞中的表达。结果:腺上皮细胞HOXA11在分泌中晚期表达量较增生期和分泌早期显著降低;基质细胞HOXA11的表达从增生期到分泌期逐渐增加,以分泌中晚期表达量最高。结论:内膜腺上皮和基质细胞HOXA11表达在分泌中晚期变化最显著,而且其表达量呈反相变化,即腺上皮表达量下降,基质细胞表达量增加。提示HOXA11基因与着床期子宫内膜的分化、成熟密切相关;其对内膜腺上皮和基质细胞的调控机制可能不尽相同。     

不明原因反复种植失败患者“种植窗”期血清雌二醇、孕酮增高与肿瘤坏死因子受体

目的 探讨不明原因反复种植失败（RIF）和正常生育妇女（FC）“种植窗”期血清雌二醇（E2）、孕酮（P）、E2/P水平和子宫内膜组织学时相、雌激素受体（ER）、孕激素受体（PR）和肿瘤坏死因子受体作用因子3（TRAF3）蛋白质的表达及其变化差异与反复种植失败的关系。方法 2009年10月至2012年3月于中山大学附属第一医院募集34名女性自愿者（反复种植失败患者15例,生育对照组19名）。在黄体生成激素（LH）+6~LH+9 d检测血清E2、P水平,微创法取子宫内膜组织;应用Western blot进行TRAF3的蛋白质水平半定量分析,免疫组织化学技术分析ER、PR和TRAF3定位表达与图象半定量分析。结果 “种植窗”期血清E2、P水平,子宫内膜腺上皮细胞ER、PR,基质细胞ER、PR在两组间差异无统计学意义,但RIF患者血清E2/P显著高于对照组（[WTBX]P[WTBZ]=0.026）。免疫组织化学法分析显示TRAF3主要定位于子宫内膜腔上皮和腺上皮细胞,基质细胞表达很弱;免疫组化染色光密度值分析和Western blot半定量结果均显示不明原因RIF组TRAF3表达显著降低（[WTBX]P[WTBZ]=0.02）。结论 “种植窗”期子宫内膜组织存在TRAF3的定位与半定量表达;E2/P升高可能影响子宫内膜组织局部分子的表达。     

Intratumoral effects of medroxy-progesterone on proliferation, apoptosis, and sex steroid receptors in endometrioid endometrial adenocarcinoma

OBJECTIVE: The effects of progesterone on proliferation and apoptosis are studied in a scrutinized evaluation of endometrial carcinoma before, during, and after progesterone therapy. The heterogeneity of sex steroid expression as well as proliferation, indicated as Ki-67 index, is considered. METHODS: A total of 29 endometrial carcinomas were studied with in situ evaluation of Ki-67 proliferation marker, estrogen and progesterone receptors (ER and PR), and bcl-2 and p53 immunohistochemistry in the epithelial part of the tumor. In biopsy 1, before the therapy, Ki-67 ER, and PR were studied also in stroma. Apoptotic cells were morphologically identified in hematoxylin- and eosin-stained sections of the tumors and the apoptotic index (apoptotic cells per 1000 cells) was calculated. Chances in feature factors were mainly evaluated by repeated measures ANOVA. RESULTS: Proliferation (Ki-67) was decreased in grade 1 (G1) and grade 2 (G2) tumors during progesterone therapy both in overall evaluation (Ki) and particularly in the areas of maximal proliferation (Ki-max). No change was seen in G3 tumors. A decrease in PR expression in the areas of maximal expression for PR (PR-max) was also observed in G1 and G2 tumors. Apoptosis as well as bcl-2 and ER expression were unchanged during therapy and withdrawal. CONCLUSIONS: The effect of progesterone is seen only on proliferation in low-grade (G1 and G2) tumors. The coexistence of high PR expression in the foci of high proliferation may contribute to the effect in G1 and G2 tumors. No effect of progesterone is seen on apoptosis in tumors of any grade.     

Abnormal expression of sex steroid receptors and cell cycle-related molecules in adenocarcinoma in situ of the uterine cervix.

It was recently reported that cervical adenocarcinoma showed an abnormal expression of estrogen receptor (ER) and cell cycle-related molecules (cyclin E, p53, p16, p21, and p27). To investigate whether similar alterations exist in glandular intraepithelial lesions, the expression of ER, progesterone receptor (PR), Ki-67, and the above cell cycle-related molecules was examined in 15 cases of glandular dysplasia (GD) and 10 cases of adenocarcinoma in situ (AIS), using the immunohistochemical technique. An expression of ER and PR was often decreased or missing in GD and, especially, in AIS. The Ki-67 labeling index was significantly higher in AIS than in GD or normal glandular cells. In GD, expression of all the cell cycle-related molecules was not recognized (except for a few p27-positive cases), a situation comparable to normal glands. In contrast, an abnormal expression of all the cell cycle-related molecules examined was demonstrated in AIS. There was a significant positive correlation, in terms of the extent of staining, between cyclin E and p21 in AIS. These results suggest that an altered expression of these molecules occurs in AIS as it does in invasive adenocarcinoma, and provide additional evidence supporting AIS as a precursor of cervical adenocarcinoma.     

子宫内膜癌患者血清及病理分子标志物与其病理特征关系的研究

目的探讨子宫内膜癌组织中癌基因表达及血清学肿瘤标志物水平与其临床病理特点及预后的相关性。方法回顾性分析467例原发性子宫内膜癌患者的临床病理资料。并按照临床预后的高危因素将子宫内膜癌患者分为高危组和低危组。采用免疫组化法检测其组织中雌激素受体（ER）、孕激素受体（PR）、PTEN、p53和Ki-67基因的表达,电化学发光法和酶联免疫法检测血清中CA125、CP2、CA199及唾液酸（SA）等肿瘤标志物,分析各项肿瘤标志物与其临床病理特征的相关性。结果不同临床病理分期ER、PR、PTEN、CA125和CP2表达比较,差异均有统计学意义（P〈0.05）,不同病理分级ER、PR、Ki-67和SA表达比较,差异有统计学意义（P〈0.05）,不同肌层浸润深度PR、CA125和CA199表达比较,差异均有统计学意义（P〈0.01）,有无淋巴结转移ER、PR、CA125和CP2表达比较,差异均有统计学意义（P〈0.01）,有无脉管内癌栓CA125和SA表达比较,差异有统计学意义（P〈0.05）,有无腹水癌细胞CA125表达比较,差异有统计学意义（P〈0.001）。高危组PR表达显著低于低危组（P〈0.05）,高危组Ki-67、CA125、CA199和CP2的表达均显著高于低危组（P〈0.05）,两组中ER、p53、PTEN和SA表达比较,差异均无统计学意义（P〉0.05）。结论 PR、Ki-67、CA125、CA199和CP2与子宫内膜癌的预后密切相关,有助于指导临床治疗。     

Fhit和ki-67在子宫内膜异位症的表达及意义

目的:通过观察脆性组氨酸三联体Fhit和细胞核增殖抗原ki-67在子宫内膜异位症的表达,探讨Fhit和ki-67在子宫内膜异位症发病中的作用。方法:用免疫组化SP法检测58例子宫内膜异位症(EMS)患者的异位内膜和在位内膜及15例子宫肌瘤患者子宫内膜(对照组)Fhit和ki-67的表达。结果:Fhit主要在腺上皮细胞的胞浆和胞膜表达,其表达强弱顺序为:对照组子宫内膜>EMS组在位内膜>EMS组异位内膜,EMS在位和异位内膜Fhit表达在增生期和分泌期无统计学差异(P>0.05);EMS组在位内膜的Fhit表达在临床r-AFS不同分期中无统计学差异(P>0.05),但异位内膜的Fhit表达在临床r-AFS不同分期中差异显著。ki-67主要在腺上皮细胞的胞核和胞膜表达,EMS在位内膜和对照组子宫内膜增生期ki-67表达均显著强于分泌期,EMS异位内膜腺体中ki-67表达在增生期和分泌期无统计学差异(P>0.05);EMS组异位内膜腺体ki-67表达在增生期弱于自身在位内膜(P<0.01),但分泌期强于其自身在位内膜(P<0.01)。EMS异位内膜腺体Ⅰ~Ⅱ期的ki-67表达高于Ⅲ、Ⅳ期,但在位内膜ki-67表达在不同临床分期中无统计学差异(P>0.05)。结论:Fhit和ki-67可能与子宫内膜异位症有关。     

米非司酮对离体异位与在位子宫内膜雌、孕激素受体含量的影响

目的　探讨子宫内膜异位症(内异症)的异位与在位内膜雌、孕激素受体(ER、PR)含量,及米非司酮对其影响。方法　采用免疫细胞化学法,分析22例内异症患者的在位内膜细胞和其中12例患者的异位内膜细胞体外培养后的ER、PR含量,观察不同浓度米非司酮(1×10-6mol/L和1×10-4mol/L)作用后的变化,并以13例正常子宫内膜作对照。结果　内异症的在位内膜ER、PR含量呈明显周期性变化,分泌早期腺体PR含量显著高于正常子宫内膜［组织化学评分(下同)为2.77±0.32与2.20±0.26,P<0.05］。内异症的异位内膜,增殖期ER(腺体0.65～2.17,间质0.45～1.03)、PR含量(腺体0.55～1.77,间质0.40～1.27)显著低于在位内膜(ER腺体1.50～3.23,间质0.80～1.96;PR腺体1.55～3.34,间质0.98～2.50,P<0.05～0.01);分泌早期无差异;分泌晚期腺体ER含量(3.27±0.31)、PR含量(3.33±0.23)与间质ER含量(1.87±0.31)显著高于在位内膜(分别为0.28±0.11、0.36±0.23和0.26±0.15,P<0.01),而间质PR含量无差异。米非司酮可明显降低内异症的异位和在位内膜ER、PR含量(P<0.01),且米非司酮浓度越高,ER、PR含量降低越明显。结论　内异症的异位和在位内膜ER、PR含量明显不同,米非司酮可下调异位和在位内膜ER、PR的含量。