子宫内膜增生过长患者雌、孕激素水平、孕激素受体及B亚型的表达

目的:探讨子宫内膜增生过长患者雌孕激素水平、孕激素受体(PR)及B亚型(PR-B)的表达,为临床内 分泌治疗及预后判断提供理论依据。方法:应用SP免疫组化技术,检测51例增生过长患者子宫内膜(单纯增生20 例,复合增生16例,非典型增生15例)的PR、PR-B表达,并对其中36例行外周血雌二醇(E2)、孕酮(P)放射免疫分析测定,同时选取20例正常月经增生期妇女作对照组。结果:①子宫内膜增生过长患者外周血E2、P与对照组相比,差异无统计学意义(P>0.05)。②正常增生期与不同类型增生过长患者的子宫内膜PR表达差异无统计学意义(P>0.05);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PR-B表达明显低于其他各组,差异有统计学意义(P<0.01);③内膜增生过长患者PR、PR-B阳性表达组外周血E2、P与非表达组间差异无统计学意义(P>0.05)。结论:①单次检测外周血E2、P对子宫内膜增生过长患者无临床意义。②不同类型增生过长的子宫内膜,PR表达无差异;PR-B下调可能与子宫内膜增生过长的发生发展癌变有关。③在子宫内膜增生过长患者外周血E2、P与内膜腺体细胞PR、PR-B表达无明显相关关系。

Expression of PR, PR-B and the serum level of E2, P in endometrial hyperplasia

Aim: To study the expressions, biological characters of PR, PR-B in endometrial hyperplasia for providing theoretical basis of medical treatment and prognostic value. Methods: The expressions of PR,PR-B were examined by SP immunohistochemical method in 51 cases of endometrial hyperplasia(20 cases of simple endometrial hyperplasia, 16 cases of complex endometrial hyperplasia and 15 cases of atypical endometrial hyperplasia). The levels of E2, P in serum were examined by radioimmunoassay in 36 cases among them. At the same time 20 cases at normal proliferative phase were detected as the control group. Results:The levels of E2, P in serum in endometrial hyperplasia were as equal as those in normal proliferative phase. There were no significant differences among 4 groups (P >0. 05). The expression of PR had no significance in endometrial hyperplasia ( P > 0. 05 ). Positive PR-B expression abated from simple hyperplasia, complex hyperplasia to atypical endometrial hyperplasia. There was the lowest expression especially in atypical endometrial hyperplasia (P < 0.01). The levels of E2 , P in serum in the group with PR, PR-B positive were as equal as those in the negative group (P >0.05). Conclusion: The estrogen level in serum has no clinical significance in endometrial hyperplasia. The expression of PR has no significant changes among the different types of endometrial hyperplasia. The change of PR-B expression was correlated with the genesis, progression and tumor-changing of endometrial hyperplasia. The levels of E2, P in serum may not relate with the expression of PR, PR-B in endometrial hyperplasia.