大剂量米非司酮对绝经后子宫内膜息肉的雌、孕激素受体及Ki-67、Bcl-2的影响.pdfVIP

· 临床研究 · 2008年6月第5卷第17期 大剂量米非司酮对绝经后子宫内膜息肉的 雌、孕激素受体及 Ki一67、Bcl一2的影响 吴小容 (广东省湛江中心人民医院妇产科，广东湛江 524300) 【摘要】目的：通过检测米非司酮(RU486)治疗绝经后子宫内膜息肉(EP)前后的雌、孕激素受体(ER、PR)及 Ki一67、 Bel一2水平变化，探讨子宫内膜息肉的药物治疗方法。方法：绝经后子宫内膜息肉患者458例．均接受官腔镜下子宫 内膜息肉切除术(TCRP)，术后病理诊断均为子宫内膜息肉，并采用免疫组化法检测子宫内髅息肉中雌、孕激素受 体及Ki_67、Bcl一2的表达；随访以上患者，术后3个月～3年复发160例(经官腔镜检查)，均予大剂量米非司酮口服 治疗，3个月后行官腔镜检查，有残余息肉者55例，再行TCRP，并采用免疫组化法检测子宫内膜息肉中雌、孕激素 受体及Ki一67、Bcl一2的表达。结果：米非司酮治疗复发子宫内膜息肉160例，105例EP消失，。55例EP缩小，子宫内 膜息肉中雌、孕激素受体及Ki一67的表达均较服药前明显降低，而Bct一2变化不大。结论：大剂量米非司酮通过降调 子宫内膜息肉中雌、孕激素受体及Ki一67的表达而有效治疗子宫内膜息肉。 【关键词】米非司酮；绝经后子宫内膜息肉；雌激素受体；孕激素受体 【中图分类号】R711 【文献标识码】 A 【文章编号1 1673-7210(2008jO6《白J D40_02 Effect of large dose mifepristone on the expression of estrogen~ eeptors， progesterone receptors,Bcl-2 and Ki-67 in ~ tmenopausal eadametrial polyps WUXiao—rong (Department of Obstetrics and Gynaecology，centra1 Peoples Hospital of zh龃jia玎 压蛐jiarIg 524300,ChiBa) [Abstract】0bjective：To explore the expression IIf鳓忸=0lgen receptors(ER)，progesterone reeeptom(PR)，Bel-2 mid Ki-67 in postmenopausal endometrial polyps before and after the treatment by large dose mifepristone fRU486)． 【d啦喇 458 post- menopausal endometrial polyps were all treated by tra~eervieal recection of polypffCRP),and diagnosed by tml~logy．The presence of ER，PR，Bcl-2 and Ki一67 were detected by immunohistoehemieal staining．Following up these ca 160 cases recured in three months to three years after treatment．These recurrence were treated by large dose mifepristone,．A~Lte,r three months，55 cases remainder EP were detected by hysteroseopy and treated by TCRP，then detected the presence of above receptors in the same way．Results：Among the 160 reem-tence EP treated by RU486,105 cases were