文档介绍：雌、孕激素受体与妊娠滋养细胞肿瘤预后的相关性
作者:安瑞芳,张晓华,李瑾,李艳萍
【摘要】目的探讨雌激素受体(ER)及孕激素受体(PR)在妊娠滋养细胞肿瘤(GTT)中的表达及其意义。方法应用免疫组织化学(SP)法检测34例GTT中ER、PR的表达情况,以正常早孕绒毛20例、葡萄胎首次清宫组织30例为对照。结果在正常早孕绒毛、葡萄胎、GTT组织滋养细胞中,ER %、%、%,随着滋养细胞恶性程度的增加ER染色阳性细胞数及染色强度降低且差异有统计学意义(P<);PR在正常早孕绒毛、GTT组织滋养细胞中无表达,在葡萄胎中表达很少,PR染色与滋养细胞恶性程度无关(P>)。在GTT组织中,ER与临床病理特征密切相关(P<)。结论 ER表达与GTT恶性程度相关,提示对ER的监测有助于判断疗效及预后,且为GTT的激素治疗提供了可行性的理论依据。
【关键词】妊娠滋养细胞肿瘤;葡萄胎;雌激素受体;孕激素受体
ABSTRACT: Objective To explore the expression of estrogen receptor (ER) and progesterone receptor (PR) in gestational trophoblastic tumor (GTT) and their significance. Methods The expression of ER and PR in 34 cases of GTT was detected by immunohistochemical method; 20 cases of normal villi and 30 cases of hydatiform mole served as controls. Results The positive expression rate of ER in normal villi, hydatiform mole and GTT was %, % and %, respectively, and had positive correlation with the malignance degree of GTT. The positive expression rate of PR in normal villi, hydatiform mole and GTT was little. The expression of ER was closely related to these clinicopathological features of GTT (P<). Conclusion The expression of ER was associated with the development and malignance of GTT. The monitoring of ER is valuable in judging the curative effect and predicting the prognosis of GTT. In addition, they could provide the theoretical foundation and experimental evidence for further hormone therapy.
KEY WORDS: gestational trophoblastic tumor; hydatidifore mole; estrogen receptor; progesterone receptor
妊娠滋养细胞肿瘤(gestational trophoblastic tumor, GTT)包括侵袭性葡萄胎、绒癌、胎盘部位滋养细胞肿瘤,其恶性程度高、转移早,如果能早期诊断且给予及时有效治疗,不仅能够被治愈而且大部分患者的生育能力也能够被保存[1]。由于病因至今不明,所以早期确定GTT的性质、及时化疗、判断化疗效果及预测病变转归是治疗的关键。近年来,越来越多的研究表明雌激素受体(estrogen receptor, ER)、孕激素受体(progesterone receptor, PR)的低水平表达与多种人类肿瘤的发生发展、侵袭转移密切相关。本文采用免疫组化法检测ER、PR在GTT中的表达,旨在探讨二者与GTT预后的关系。
1 对象与方法
研究对象选择1996年12月至2006年12月西安交通大学医学院第一附属医院妇产科GTT组织标本34例作为研究组,其中侵蚀性葡萄胎24例,绒毛膜癌10例