肺肿瘤与雌激素关系及治疗探讨

目的研究雌激素、雌激素受体(ER)、孕激素受体(PR)与人类肺恶性肿瘤发生、发展之间的关系,探讨肺肿瘤内分泌治疗的可能性。方法利用组织化学技术检测56例肺肿瘤组织标本ER、PR表达,然后应用典型的雌激素受体拮抗剂-他莫昔芬(tamoxifen)治疗受体表达阳性的且化疗无效的晚期肺肿瘤患者16例,观察其治疗效果及副作用。结果人类自然发生的肺肿瘤细胞含有ER、PR,其阳性率分别为42.9%和30.4%;腺癌ER、PR的阳性率71.4%和35.7%明显高于鳞癌的31.0%和17.2%(P<0.05);ER与PR的表达明显正相关(P<0.05);自化疗开始1~3疗程无进一步改善的肺癌者16例,TAM治疗后7例缓解或稳定,生存期8~24个月,平均14个月。TAM治疗无明显毒副作用。结论部分肺肿瘤细胞含有ER、PR,意味着这些肿瘤有雌激素依赖性,其发生、发展可能受雌激素调控,内分泌治疗有效;晚期肺癌患者如果ER、PR阳性,加用雌激素受体拮抗剂可能会有一定效果;TAM对临床难治性、ER阳性的肺癌有一定疗效且毒副作用不大,可在临床进一步试用。

The relationship and therapy between lung cancer and estrogen receptor

Objective: To investigate the relationship of estrogen,estrogen receptor(ER) and progesterone receptor (PR )with human lung cancer. Methods: We first utilized the histochemistry technology to examine the expression of ER,PR of 56 lung cancer sample,then applied the typical ER acceptoantagonist-Tamoxifen(TAM) to treat 16 advanved lung cancer patients who had no effection on chemotherapy but the receptor expressions were positive.Results: There were ER and PR in human lung cancer, the positive rates were 42.9% and 30.4% separately. For adenocarcinoma positive rates of ER and PR were 71.4% and 35.7% separately and obviously higher than that of squamous cell carcinoma which were 31.0% and 17.2% separately(P<0.05). The expression of ER and PR was positively correlated is obvious (P<0.05);Seven of 16 lung cancer patients which had no effect after 1~3 period of chemotherapy were relaxed or stabilized through treatment with TAM.The survival time was 8~24month,and the everage 14 month.TAM had no serious side effect. Conclusion: Lung tumour cells have ER and PR, For the advanced lung malignancy patients,if the ER and PR are positive,there maybe have certain degree effect by incretion therapy. TAM has certain curative effect on lung cancer patients with positive ER or PR.