雌、孕激素受体表达与宫腔粘连分离术后雌孕激素治疗疗效的相关性研究

目的:研究宫腔粘连(IUA)患者子宫内膜组织中雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)的表达,探讨其与术后雌孕激素治疗疗效的关系。方法:采用免疫组化法检测55例中重度IUA患者子宫内膜组织的ER、PR表达;患者均行宫腔镜下IUA分离术,术后给予雌孕激素周期治疗。随访患者的月经改善情况,结合宫腔镜复查结果,分析PR、ER受体与预后的相关性。结果:ER、PR在腺体及间质中的表达均无显著差异(P=0.727,P=0.453);PR低表达组、高表达组患者术后雌孕激素治疗的有效率分别为63.64%和54.55%,两组比较无显著差异(P=0.503);ER低表达组、高表达组患者术后雌孕激素治疗的有效率分别为33.33%和70.27%,两组比较差异显著(P=0.018)。结论:患者子宫内膜PR的表达不能预测预后;ER表达水平与疗效呈正相关,其可能成为IUA术后雌孕激素治疗疗效的预测指标。

The study of correlation between the expression of estrogen receptor,progesterone receptor and the effect of hysteroscopic adhesiolysis with estrogen and progesterone therapy

Objective： To study the expressions of estrogen receptor（ ER） and progesterone receptor（ PR） in patients with intrauterine adhesions（ IUA）,and investigate the correlation between the expression and the effect of the hysteroscopic adhesiolysis combined with estrogen and progesterone therapy. Methods： Fifty-five patients diagnosed as moderate or serious IUA by hysteroscopy were enrolled. The patients＇ endometrial tissues were investigated for the expressions of ER and PR by immunochemistry. Then,the patients received hysteroscopic adhesiolysis,and underwent estrogen and progesterone cycle therapy. The patients were followed up and reexamined by hysteroscopy regularly. Chi-square test was use to analyze the correlation between the expression and prognosis. Results： Both the expressions of ER and PR were not statistic significantly different between glands and stroma（ P = 0. 727,P = 0. 453）. The effective rates of estrogen and progesterone cycle therapy in low PR expression group and high PR expression group were 63. 64% and 54. 55%,respectively. There was no significant difference between them（ P = 0. 503）. The effective rates of estrogen and progesterone cycle therapy in low ER expression group and high ER expression group were 33. 33% and 70. 27%,respectively. There was significant difference between them（ P = 0. 018）. Conclusion： The expression of PR in endometrium may not be a predictor of prognosis. The effect of estrogen and progesterone cycle therapy is positive correlated with ER expression in endometrium of IUA patients. And ER expression is expected to be a prognostic marker of the effect of the hysteroscopic adhesiolysis combined with estrogen and progesterone therapy.