子宫肌瘤表皮生长因子及其受体临床观察分析

目的：探讨子宫肌瘤患者血清表皮生长因子及肌瘤组织表皮生长因子受体的基因变化。方法：收集子宫肌瘤患者,采用清热化瘀法治疗1个疗程共37例,在治疗前后对比症状、体征、肌瘤体积、血清EGF变化。同时对部分切除子宫肌瘤患者的肌瘤组织及血清做免疫组化基因表达测定表皮生长因子受体（EGFR）。结果：治疗前后症状积分降低〉50%,P〈0.05;肌瘤体积在治疗前后稍有改善,但P〉0.05。EGF在治疗前平均（1.25±0.28）μg/L,治疗后平均（1.07±0.16）μg/L,前后对比P〈0.05。基因测序检测EGFR,观察到肌瘤组织EGFR可发生第19外显子的E746-I759缺失性突变,突变频率为6.2%,而相应病人的血液细胞未能查出突变。结论：清热化瘀药可能下调血清EGF水平,控制子宫肌瘤的发展;通过基因测序可以判断肌瘤的生物学行为。

The Clinical Analysis of Epidermal Growth Factor and Its Receptor in Uterine Leiomyoma

Objective：To study the changes of the epidermal growth factor（EGF） and its receptor（EGFR） in the patients with uterine leiomyoma.Methods：37 patients with uterine leiomyoma were treated by purifying heat and removing blood stasis drugs for one course.The factors measured included the changes of symptoms,sings,the volume of the leio-myoma,the serum EGF level and the mutation of EGFR gene which was tested in the leiomyoma tissue by immunohisto-chemistry.Results：The accumulated points of the symptoms has reduced more than 50% after the treatment（P 〈 0.05）,but the volume of the leiomyoma did not change significantly（P 〉 0.05）.The mean serum EGF level was（1.25 ± 0.28） ug/L before the treatment,which significantly reduced to（1.07 ± 0.16） ug/L after the treatment（P 〈 0.05）.It was found in the leiomyoma tissue that the mutations in exon 19 of EGFR were in frame deletion of the codon E746-I759.The frequency of such mutation was 6.2%.But we did not find the same result in blood samples with the same pa-tients.Conclusion：The purifying heat and removing blood stasis drugs can regulate down the serum EGF level and control the development of the leiomyoma;The mutations can be detected by direct gene sequencing that will enable us to get a potential implication in the biologic behavior of the uterine leiomyoma.