孕酮受体、孕酮受体B亚型和增生细胞核抗原在子宫内膜增生过长组织中的表达

目的 :研究孕酮受体及其B亚型 (PR、PR B)在子宫内膜增生过长组织中的表达特点及意义 ,探讨子宫内膜增生过长的发病机制 ,为临床内分泌治疗及预后判断提供理论依据。方法 :采用免疫组化SP法检测 5 1例子宫内膜增生过长 (单纯增生 2 0例 ,复合增生 16例 ,非典型增生 15例 )和 2 0例正常月经增生期子宫内膜组织中PR、PR B、增殖细胞核抗原 (PCNA)的表达。结果 :①不同类型增生过长的子宫内膜PR表达无差异 (P >0 0 5 )。②从单纯增生 ,复合增生到非典型增生内膜组织中PR B表达逐渐下降 ,其中非典型增生组明显低于其它各组 ,差异有极显著性 (P <0 0 1)。③从正常增生、单纯增生、复合增生到非典型增生 ,PCNA表达逐渐增强 ,其中复合增生与非典型增生明显高于单纯增生及正常增生期子宫内膜 (P <0 0 5 )。④PCNA与PR表达无相关关系 (P >0 0 5 ) ;PCNA与PR B表达存在负相关关系 (P <0 0 5 )。结论 :PR水平变化不足以说明其在内膜增生过长发病中的作用及意义 ;PR B表达下降参与了子宫内膜增生过长的发生、发展及癌变过程 ,提示联合检测PR B、PCNA既可预测患者对内分泌治疗的反应 ,也可作为判断预后指标

Study on the expression of PR,PR-B and PCNAin endometrial hyperplasia

Objective: To study the expression and the biological character of PR,PR B in endometrial hyperplasia and the pathogenetic mechanism of endometrial hyperplasia for providing theoretical basis of medical treatment and prognostic value. Methods: The expressions of PR, PR B?PCNA were examined by SP immunohistochemical method in 51 cases with endometrial hyperplasia (20 cases with simple endometrial hyperplasia, 16 cases with complex endometrial hyperplasia and 15 cases with atypical endometrial hyperplasia). At the same time 20 cases with normal proliferative phase were chosen as control group. Results: The expression of PR has no significance in endometrial hyperplasia ( P >0 05). Positive PR B expression abated from simple hyperplasia, complex hyperplasia to atypical endometrial hyperplasia. There were the lowest expression especially in atypical endometrial hyperplasia ( P <0.01). The expression of PCNA of atypical and complex hyperplasia were significantly higher than that of simple hyperplasia and normal proliferative phase ( P <0.05). The frequency of PR B protein expression in the group with PCNA positive staining was significant lower than that in the negative group ( P <0.05). Conclusion: The changes of PR was of no significance in pathogenesis of endometrial hyperplasia. The changes of PR B was related with the genesis, progression and tumor changing of endometrial hyperplasia. PR B and PCNA may be useful markers to predict curative effect and prognosis.