颅内动脉瘤患者瘤壁雌激素和雄激素受体的表达及其作用

目的探讨颅内动脉瘤壁雌激素和雄激素受体表达水平的意义。方法前瞻性纳入2007年11月至2016年6月在四川大学华西医院接受开颅手术夹闭颅内动脉瘤的患者32例,获得颅内动脉瘤壁19个,颞浅动脉分支26个,共45个合格标本。采用免疫组化法检测颞浅动脉分支和颅内动脉瘤壁平滑肌层及内皮细胞的雌激素受体-α、β及雄激素受体表达水平。以Image Pro Plus6.0软件分析检测阳性细胞表达水平积分光密度值。统计学分析采用χ2检验,成组Mann-Whitney秩和检验。结果动脉瘤壁的雌激素受体-α、β表达中位数(M)与四分位距(P25,P75)分别为3 049(2 112,5 554)和4 364(2 314,5 667),低于颞浅动脉分支的6 544(3 507,10 103)和6 972(5 694,10 024)。动脉瘤壁雄激素受体表达水平3 299(1 375,4 895),高于颞浅动脉分支的1 130(794,1 922),两组比较差异均有统计学意义(均P0.05)。结论脑血管壁雌激素受体-α、β表达水平的降低,雄激素受体表达水平的升高,可能促进了颅内动脉瘤的进展,但具体机制尚需进一步研究。

Expression of estrogen and androgen receptors on aneurysm walls and their effects in patients with intracranial aneurysm

Objective To investigate the significance of androgen and estrogen receptor expression levels on aneurysm walls.Methods From November 2007 to June 2016,32 patients received craniotomy for clipping intracranial aneurysms in the West China Hospital,Sichuan University were enrolled prospectively.Nineteen intracranial aneurysm walls and 26 superficial temporal artery branches were obtained (a total of 45 qualified specimens).Immunohistochemical method was used to detect the superficial temporal artery branches and smooth muscle layer of intracranial aneurysm wall and the expression levels of estrogen receptor-α,β and androgen receptors.Image Pro Plus 6.0 software was used to analyze and detect the integral optical density values of the positive cell expression levels.The χ2 test and rank-sum test were used for statistical analysis.Results The median (M) and interquartile range (P25,P75) of the expression levels of estrogen receptor-α,β of the intracranial aneurysm walls were 3 049 (2 112,5 554) and 4 364 (2 314,5 667) respectively.They were lower than 6 544 (3 507,10 103) and 6 972 (5 694,10 024) of the superficial temporal artery branches.The expression level of androgen receptor of aneurysm wall was 3 299 (1 375,4 895),it was higher than 1 130 (794,1 922) of the superficial temporal artery branches.There was significant difference between the two groups (all P<0.05).Conclusion The decreased expression levels of estrogen receptor-α,β and the increased expression level of androgen receptor in the cerebrovascular walls may promote the progress of intracranial aneurysms,however,the specific mechanism needs further study.