子宫肌瘤中孕激素受体/雌激素受体在月经周期中的变化

目的:研究子宫肌瘤中孕激素受体/雌激素受体在月经周期中的改变,探讨子宫肌瘤的生长与雌、孕激素受体的关系,为临床上药物治疗子宫肌瘤提供进一步的理论依据。方法:采用免疫组化方法,检测42例子宫肌瘤患者的肌瘤组织和正常肌组织中雌、孕激素受体的表达情况,通过积分的方式计算两者比值。结果:子宫肌瘤组织中雌、孕激素受体阳性率明显高于正常肌组织,两组之间有显著差异(P<0.05);肌瘤组PR/ER在子宫内膜增殖期与分泌期均低于肌组织,分泌期肌瘤组与正常组PR/ER分别高于增殖期(P<0.05)。结论:子宫肌瘤的生长,雌激素及雌激素受体在月经周期中都起着重要作用;孕激素及孕激素受体同样起着一定的作用,且以月经后半期为主。     

子宫肌瘤患者雌、孕激素水平在月经周期中的变化

目的:研究子宫肌瘤患者血清雌、孕激素水平在月经周期中的变化,探讨子宫肌瘤的生长与血清雌、孕激素水平的相关性。方法:对我院因子宫肌瘤而行子宫全切或次切的48例患者进行研究分析,年龄34~55岁,所有病例均经手术后病理证实为子宫肌瘤,近3个月未用过任何激素类药物,用化学发光免疫组化方法检测血清雌、孕激素水平。同时选取38例月经规则、子宫及附件正常的妇女测定血清雌二醇及孕酮含量作为对照组,年龄36~47岁。结果:子宫肌瘤组与正常对照组血清雌二醇、孕激素水平在月经周期不同时期无显著差异。结论:子宫肌瘤不仅仅是在外周雌、孕激素作用下发生的,在子宫肌瘤的发生、发展过程中可能存在其它更重要的因素,尚需进一步探讨。     

子宫肌瘤中IGF-1受体的变化及其与雌、孕激素受体的关系

目的:探讨人子宫肌瘤及周围正常子宫平滑肌细胞中胰岛素样生长因子受体(IGF-1R)的变化及其与雌、孕激素受体的关系。方法:免疫组织化学SABC法检测雌激素受体(ER)、孕激素受体(PR)、胰岛素样生长因子受体(IGF-1R)的表达,并对其进行图像分析。结果:子宫肌瘤细胞中ER、PR、IGF-1R的表达明显高于子宫肌层细胞中的表达。结论:子宫肌瘤的生长与子宫肌瘤组织ER、PR、IGF-1R的表达增强有关。     

雌激素受体联合孕激素受体蛋白在子宫肌瘤患者中的表达及辅助价值分析

目的 探讨雌激素受体(ER)联合孕激素受体(PR)蛋白表达在子宫肌瘤患者中的辅助价值及治疗指导效果。方法 选择东阳市人民医院巍山分院2020年1月—2022年9月子宫肌瘤患者96例为研究对象,手术提取子宫肌瘤病灶组织和正常子宫组织。介质免疫组织化学法检测不同组织中ER、PR蛋白阳性率;查阅患者病历资料,分析不同临床特征下ER、PR蛋白表达阳性率;绘制ROC曲线,分析ER联合PR在子宫肌瘤治疗中的指导效能。结果 ER与PR蛋白在子宫肌瘤患者病灶组织中阳性率分别为59.38%和63.54%,均显著高于正常组织(4.17%和6.25%),差异均有统计学意义(均P<0.05);免疫组化染色结果表明：子宫肌瘤病灶组织ER与PR蛋白表达于细胞质与细胞核,呈棕褐色、棕黄色,着色度较高;而正常组织中阳性染色细胞较少,ER与PR蛋白着色程度较低;子宫肌瘤患者病灶组织中ER和PR蛋白表达阳性率与病理类型、绝经比较差异有统计学意义(P<0.05);ROC曲线结果表明：ER联合PR治疗子宫肌瘤指导灵敏度为93.75%,显著高于单一蛋白(70.31%和82.81%),差异均有统计学意义(均P<0.05);特异度为72.86%,显著低于单一指标(85.00%和89.14%),差异均有统计学意义(均P<0.05)。结论 ER和PR蛋白在子宫肌瘤患者中呈高表达,其表达阳性率与病理类型和是否绝经有关,二者联合检测能提高治疗指导灵敏度。     

外周血胰岛素样生长因子-Ⅰ和Ⅱ水平与子宫肌瘤组织中雌孕激素受体的关系研究

目的探讨外周血胰岛素样生长因子-Ⅰ(IGF-Ⅰ)和胰岛素样生长因子-Ⅱ(IGF-Ⅱ)水平与子宫肌瘤组织中雌孕激素受体的关系。方法选取2013年1月-2016年1月期间就诊于该院的154例子宫肌瘤患者为研究组,同时选取同期在该院进行体检的健康女性154例为对照组。分别采用酶联免疫吸附试验法及免疫组化方法测定两组患者外周血中IGF-Ⅰ、IGF-Ⅱ水平及子宫肌瘤组织雌激素受体(ER)、孕激素受体(PR)的表达情况,并分析两者之间的相关性。结果研究组患者外周血中IGF-Ⅰ和IGF-Ⅱ水平远高于对照组患者(P<0.05);研究组中ER(+)及PR(+)患者外周血中IGF-Ⅰ和IGF-Ⅱ水平高于ER(-)及PR(-)患者(P<0.05);子宫肌瘤患者外周血IGF-Ⅰ、IGF-Ⅱ水平与ER及PR均存在正相关性(均P<0.05)。结论 IGF-Ⅰ和IGF-Ⅱ的水平对子宫肌瘤的发生具有一定的影响,且与肌瘤组织的ER及PR存在呈正相关。     

雌、孕激素受体及表皮生长因子受体表达与子宫肌瘤术后复发的相关性研究

目的 探讨雌激素受体(ER)、孕激素受体(PR)、表皮生长因子受体(EGFR)表达与子宫肌瘤术后复发的关系.方法 选择行子宫肌瘤切除术的患者80例,术后随访复发情况.应用免疫组织化学SP法检测ER、PR、EGFR在肌瘤组织、肌瘤旁肌层组织(正常肌层组织)中的表达.结果 肌瘤组织中ER、PR、EGFR阳性表达率明显高于正常肌层组织[88.8％(71/80)比48.8％(39/80),92.5％(74/80)比30.0％(24/80),86.2％(69/80)比57.5％(46/80),P＜0.05].肌瘤组织中ER、PR、EGFR 阳性表达患者的术后复发率均明显高于三者阴性表达患者[42.3％(30/71)比22.2％(2/9),41.9％(31/74)比16.7％(1/6),42.0％(29/69)比27.3％(3/11),P＜0.05],且复发时间也明显短于三者阴性表达患者(P＜0.05).肌瘤组织中EGFR表达与ER、PR表达均呈正相关(r=0.837、0.702,P＜ 0.05).结论 子宫肌瘤术后复发可能与肌瘤组织ER、PR、EGFR的表达增强有关.     

雌激素和孕激素受体在宫腔粘连患者子宫内膜组织中的表达及临床意义

目的探讨雌激素受体(ER)和孕激素受体(PR)在宫腔粘连患者子宫内膜组织中的表达及临床意义。方法选取2013年1月-2017年1月武汉市新洲区人民医院收治的经宫腔镜检查并手术确诊的宫腔粘连患者91例,对照组为宫腔镜检查正常患者,共45例。所有患者在宫腔镜下用异物钳钳取适量(重约20mg)的内膜组织作为标本,进行免疫组化,实时荧光定量PCR检测。宫腔粘连术后患者采用激素治疗后,评价治疗效果。结果所有患者子宫内膜均有不同程度ER、PR的表达,腺体中ER阳性率为66.2%,PR阳性率为58.1%;内膜间质中ER阳性率为42.6%,PR阳性率为36.0%,经比较差异有统计学意义(P<0.05)。与对照组比较,运用免疫组化法宫腔粘连组患者ER蛋白表达水平较高,而PR蛋白表达水平较低,两组比较差异有统计学意义(P<0.05);运用实时荧光定量PCR检测,宫腔粘连组患者ER、PR蛋白表达水平均较高,两组比较差异有统计学意义(P<0.05)。ER高表达患者总有效率为62.9%,低表达患者总有效率为31.0%,差异有统计学意义(P<0.05),表明ER表达水平的高低与治疗效果呈正比。PR高表达患者总有效率为51.8%,低表达患者总有效率为51.4%,差异无统计学意义(P>0.05),表明PR表达与治疗效果无相关性。结论宫腔粘连术后患者可以先检测ER的表达,从而制定个性化激素治疗方案,以提高临床治疗效果。     

雌、孕激素受体在甲状腺肿瘤组织中的表达

目的：检测甲状腺肿瘤组织中ER、RP的表达，并且探讨它们的表达与肿瘤浸润转移的关系。方法：应用免疫组化方法，检测100例甲状腺癌及28例甲状腺良性肿瘤中ER、PR表达。结果：甲状腺癌中ER、PR阳性表达分别为67．0％和62．0％，均与细胞分化程度、组织学类型有关，但其阳性表达与年龄、性别无关。ER、PR在无淋巴结转移组的甲状腺癌阳性率为75．4％和70．5％，显著高于有转移组53．8％和48．7％（P＜0．05）。结论：ER、PR可作为肿瘤分化及恶性程度的评价指标，并且能反映预后。     

米非司酮对宫内膜雌激素受体及孕激素受体远期损害的相关性研究

目的:观察米非司酮对宫内膜雌激素受体(ER)及孕激素受体(PR)远期损害的影响。方法:选择36例既往有服用米非司酮紧急避孕史患者(A组),24例既往有服用米非司酮流产史患者(B组),30例既往有早期妊娠行人工流产病史的患者(C组),3组患者均有不同程度的月经量减少。患者就诊后记录其月经量改变情况,检测其血清性激素水平以及子宫内膜雌激素受体、孕激素受体表达强度。对3组结果进行统计学分析。结果:3组患者血清性激素水平比较无统计学意义,P>0.05。ER在A组中的表达分别比在B、C两组中的表达弱,差异有统计学意义,P<0.05;而在B、C两组比较差异无统计学意义,P>0.05。PR在3组中的表达情况与ER相同。在A、B、C 3组内分别做比较,ER、PR的表达强度在同一组内的差异无统计学意义,P>0.05。结论:推测大剂量服用米非司酮引起月经减少,可能与ER、PR表达下降、子宫内膜损害有关。     

雌激素受体β基因多态性与子宫肌瘤相关性研究

目的:探讨雌激素受体β基因多态性与中国北方汉族人群子宫肌瘤的关系。方法:采用聚合酶链反应-限制性内切酶片段长度多态性(PCR-RFLP)方法检测167例子宫肌瘤患者和170例健康女性的雌激素受体β基因rs1256064和rs1256049SNPs位点的基因型,应用SPSS12.0分析基因多态性与子宫肌瘤的相关性。结果:病例组与对照组人群2个SNPs的基因型分布均符合Hardy-W e inberg平衡定律;rs1256064位点的等位基因及基因型的频数在病例组和对照组间的分布差异有统计学意义(P<0.05),rs1256049位点的基因型频数在病例组和对照组间的分布差异无统计学意义,而等位基因的频数分布差异有统计学意义(P<0.05)。结论:雌激素受体β基因rs1256064位点基因多态性可能与中国北方汉族人群子宫肌瘤相关联。     

A prospective study of serum DDT and progesterone and estrogen levels across the menstrual cycle in nulliparous women of reproductive age

The authors explored whether exposure to 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) and its isomers and metabolites affects female reproductive hormones characterized by urinary pregnanediol-3-glucuronide (PdG) and estrone conjugate (E(1)C) levels. During 1996-1998, 287 newly married Chinese women nonsmokers intending to conceive were prospectively studied. Serum for DDT measurement was collected at enrollment, and daily menstrual diaries and urine specimens were collected for 1 year or until a clinical pregnancy was achieved. More than 500 menstrual cycles were studied totaling over 8,000 days. Day of ovulation was determined for each cycle, and the association of serum DDT levels with daily PdG and E(1)C levels in a +/-10-day window around ovulation was analyzed. After adjustment for covariates including age, body mass index, and occupational exposures, consistent inverse associations of most DDT forms occurred with urine E(1)C during the periovulation phase and with urine PdG during the luteal phase of the menstrual cycle. For example, a 10-ng/g increase in serum p,p'-DDE was associated with a 0.05-log(E(1)C) decrease (p = 0.03) in the periovulation phase and a 0.06-log(PdG) decrease (p = 0.03) in the luteal phase. These results support the potential for DDT to be associated with decrements in estrogen and progesterone levels at times during the menstrual cycle that are critical for ovulation and early pregnancy maintenance.     

Changes in energy expenditure during the menstrual cycle

1. Eight women were studied under metabolic-ward conditions while consuming a constant diet throughout a single menstrual cycle. Basal body temperature, salivary and urinary hormone concentrations were used in monitoring the cycle and designing the study so that whole-body calorimetry for 36 h was conducted at four phases of the cycle in relation to the time of ovulation. 2. The metabolic rate during sleep showed cyclical changes, being lowest in the late follicular phase and highest in the late luteal phase. The increase amounted to 6.1 (SD 2.7)%. Energy expenditure (24 h) also increased but the change was not statistically significant (P greater than 0.05). Exercise efficiency did not change during the cycle. 3. There were no significant changes in plasma thyroxine, 3,5,3'-triiodothyronine or free 3,5,3'-triiodothyronine concentrations to explain the metabolic rate changes; nor did they relate to urinary luteinizing hormone, pregnanediol-3 alpha-glucuronide or oestrone-3-glucuronide excretion rates. No link with salivary cortisol or progesterone concentrations was observed, but there was a small inverse relation between the individual increase in sleeping metabolic rate and the subjects' falling ratio of urinary oestrone-3-glucuronide: pregnanediol-3 alpha-glucuronide.     

Early normal menstrual cycle pattern and the development of uterine leiomyomas

It is unclear if women who develop uterine leiomyomas have had menstrual regularity or irregularity in their reproductive life. This case-control study examines the recalled menstrual cycle patterns throughout the reproductive life among women requiring hysterectomy for myomas. One hundred twenty-two women with myomas and 244 age-matched healthy controls without myomas were enrolled in Japan. The incidence of normal menstrual cycle pattern in their teens among patients with myoma was significantly higher than that among healthy controls (p < 0.01). The subset results for parous women were the same as those for all subjects. The size of the uterus in myoma patients with teenage menstrual regularity was not larger than in those with teenage menstrual irregularity. Women who developed myomas later in life tended to have early normal menstrual cycle pattern. Early menstrual regularity may enhance leiomyoma growth in early reproductive life.     

Estradiol-17β and progesterone concentrations in human endometrium during the menstrual cycle

Plasma and endometrial levels of E₂ and P were measured on different days of the menstrual cycle. The tissue concentrations of the steroids were determined in terms of wet weight, protein and DNA. There was a good correlation between the various modes of expression of tissue concentrations; the best being between protein and DNA and the least satisfactory between wet weight and DNA. P concentrations not only in plasma but also in the endometrium were significantly higher in the secretory phase than in the proliferative phase. No significant differences in plasma or tissue levels of E₂ in the different phases of the menstrual cycles could be demonstrated.     

孕激素与雌激素治疗青春期功能失调性子宫出血对比观察

目的青春期功能失调性子宫出血发病率逐年升高。本研究探讨孕激素或雌激素治疗青春期功能失调性子宫出血的疗效。方法选择2018-03-01—2019-03-31长葛市人民医院收治的青春期功能失调性子宫出血患者68例,根据年龄和月经史分为两组,每组各34例。对照组给予雌激素治疗,观察组给予孕激素治疗。治疗后,比较两组疗效、止血情况、心理状态及不良反应。结果观察组治疗有效率为97.06%,高于对照组的76.47%,χ~2=4.610,P=0.012;观察组控制出血时间为(26.37±12.56)h,低于对照组的(38.62±17.34)h,t=3.336,P=0.001;完全止血时间为(42.52±18.76)h,低于对照组的(57.43±24.49)h,t=2.818,P=0.006。治疗后,观察组心理状态评估量表(psychological state assessment scale,MSSNS)评分为(56.62±3.71)分,低于对照组的(69.46±4.14)分,t=13.468,P0.001;治疗期间,观察组不良反应发生率为11.76%,低于对照组的32.35%,χ~2=4.191,P=0.041。结论青春期功能失调性子宫出血患者采用孕激素为主的治疗可迅速止血,从而降低患者负性情绪,且不良反应较少,效果高于使用雌激素为主的治疗。     

雌孕激素受体在上皮性卵巢肿瘤中的表达和意义

目的:分析雌、孕激素受体(ER、PR)在上皮性卵巢肿瘤中的表达情况,探讨其与上皮性卵巢肿瘤发生、发展的关系,明确ER、PR在上皮性良、恶性卵巢肿瘤以及上皮性卵巢恶性肿瘤中不同的临床分期、病理分级、病理类型中的表达,从而对上皮性卵巢肿瘤的诊断、内分泌及基因治疗提供依据,以利于制定个体化的治疗方案。方法:对60例上皮性卵巢肿瘤患者病理切片采用免疫组化SP法测定ER、PR;采用SPSS软件χ2检验、四格表确切概率法进行统计学处理。结果:①在上皮性卵巢良性肿瘤(22例)中ER阳性率27.27,PR阳性率22.72,阳性率较低;在上皮性卵巢恶性肿瘤(38例)中的阳性率较高(ER76.32、PR71.05),两者比较,χ2=13.79、χ2=13.07,P<0.01,均有显著性差异。②在上皮性卵巢恶性肿瘤中不同临床分期ER、PR的表达不同,随着临床期别的上升ER、PR的阳性率呈下降趋势。早(Ⅰ、Ⅱ)、晚(Ⅲ、Ⅳ)期比较,四格表确切概率法P>0.05,无显著性差异。③在上皮性卵巢恶性肿瘤中ER、PR在不同的病理分级中的阳性表达率不同,在高分化组的阳性率最高,在低分化组阳性率最低,P>0.05,无统计学意义。④在上皮性卵巢恶性肿瘤中不同病理类型的ER、PR表达不同,浆液性(21例)与粘液性(15例)肿瘤均呈高表达,但无显著性差异,P>0.05。结论:①ER、PR的阳性表达在上皮性卵巢良、恶性肿瘤之间有显著性差异。在上皮性良性肿瘤中呈低表达,而在上皮性恶性肿瘤中呈高表达。②ER、PR阳性表达在上皮性卵巢恶性肿瘤不同的临床分期、病理分级、病理类型中的表达不同,但无显著性差异。③临床工作中通过对它们的评价制定个体化治疗方案,指导治疗、判断预后。     

Phytoestrogens and mycoestrogens bind to the rat uterine estrogen receptor

Consumption of phytoestrogens and mycoestrogens in food products or as dietary supplements is of interest because of both the potential beneficial and adverse effects of these compounds in estrogen-responsive target tissues. Although the hazards of exposure to potent estrogens such as diethylstilbestrol in developing male and female reproductive tracts are well characterized, less is known about the effects of weaker estrogens including phytoestrogens. With some exceptions, ligand binding to the estrogen receptor (ER) predicts uterotrophic activity. Using a well-established and rigorously validated ER-ligand binding assay, we assessed the relative binding affinity (RBA) for 46 chemicals from several chemical structure classes of potential phytoestrogens and mycoestrogens. Although none of the test compounds bound to ER with the affinity of the standard, 17beta-estradiol (E(2)), ER binding was found among all classes of chemical structures (flavones, isoflavones, flavanones, coumarins, chalcones and mycoestrogens). Estrogen receptor relative binding affinities were distributed across a wide range (from approximately 43 to 0.00008; E(2) = 100). These data can be utilized before animal testing to rank order estimates of the potential for in vivo estrogenic activity of a wide range of untested plant chemicals (as well as other chemicals) based on ER binding.