IGF-1及其受体在子宫平滑肌瘤中的表达以及与雌、孕激素关系

目的探讨胰岛素样生长因子1（IGF-1）及其受体（IGF-1R）在子宫肌瘤发病中的作用,以及与雌、孕激素的关系。方法采用ELISA方法测定23例子宫肌瘤患者平滑肌瘤、正常子宫平滑肌组织及血清中IGF-1、IGF-1R的表达;同时用E IA方法测定血清雌二醇（E2）、孕酮（P）水平。选择30例健康妇女作为血清指标测定的对照组。结果（1）子宫平滑肌瘤组织IGF-1、IGF-1R的表达较正常子宫平滑肌高（P〈0.01）。（2）子宫肌瘤组血清IGF-1表达与对照组无统计学差异（P〉0.05）：IGF-1R表达较对照组增强（P〈0.01）。（3）观察组血清增生期、分泌期E2、P水平均与对照组无统计学差异（P〉0.05）。结论子宫平滑肌瘤组织中IGF-1、IGF-1R过度表达可能是子宫肌瘤发生的机制之一,雌、孕激素介导IGF-1对子宫肌瘤的作用,IGF-1对雌、孕激素诱导肌瘤细胞生长、分化主要以自分泌、旁分泌方式在局部起作用,IGF-1可能是子宫肌瘤生长的调节因子。

Expression of IGF-1 and IGF-1R in Uterine Leiomyoma and their Relation with Estrogen and Progestogen

Objective To investigate the expression of insulin-like growth factor-1（IGF-1） and its receptor（IGF-1R） in the patients with leiomyoma and their roles in the pathogenesis.Methods ELISA was used to determine the expression of IGF-1 and IGF-1R in 23 patients＇ leiomyoma,myometrium and sera.Each patient served as self-control.EIA was used to determine the levels of estradiol（E2） and progesterone（P） in their sera.Another 30 healthy women were enrolled in as normal serum controls.Results（1） The expression of IGF-1 and IGF-1R was stronger in leiomyoma than in myometrium（P〈0.01）.（2） There was no difference in the expression of IGF-1 in the serum between the patients and the normal subjects（P〉0.05）.The expression of IGF-1R was stronger in the patients than in the normal subjects（P〈0.01）.（3） There was no significant difference in serum E2 and P at proliferation and secretion phases（P〉0.05）.Conclusion Overdue expression of IGF-1 and IGF-1R is a probable mechanism in the development of uterine leiomyoma.Estrogen and progestogen mediate the effect of IGF-1 on leiomyoma.IGF-1 acts on the growth and proliferation of leiomyoma mainly through autocrine or paracrine.It is a probable regulatory factor in the growth of leiomyom.