芳香化酶P450在子宫内膜增殖及非典型增殖组织中的表达

Aromatasecy p450 expression and clinical application in the tissues of endometrial hyperplasia and atypical hyperplasia

目的探讨芳香化酶P450在子宫内膜增殖和非典型增殖中的诊断和治疗价值。方法应用免疫组织化学SP法对子宫内膜单纯性增殖30例、复杂性增殖32例及非典型增殖54例中的芳香化酶P450、雌激素受体(ER)及孕激素受体(PR)的表达进行检测,并结合临床过程进行分析。结果在正常增生期子宫内膜组织中无芳香化酶P450的表达,子宫内膜增殖(单纯性增殖、复杂性增殖、非典型增殖)组织中芳香化酶P450呈阳性表达,阳性表达率分别为41.1%、46.1%、73.2%,阳性表达率差异有统计学意义(χ2=46.69,P<0.01);ER及PR的表达与子宫内膜组织细胞的异型性程度无关;芳香化酶P450与ER、PR在子宫内膜增殖组织中(单纯性增殖、复杂性增殖、非典型增殖)的表达不存在相关性。结论芳香化酶P450可能是子宫内膜细胞增殖及恶变的促进因素之一,并可能成为子宫内膜早期癌变的生物学标记物。ER的阳性表达说明子宫内膜增殖的发生与子宫内膜局部雌激素的刺激作用有关。PR的阳性表达可以作为子宫内膜增殖保守治疗中估计预后的有效指标。

Objective To study the value of aromatasecy P450 in the tissues of endometrial hyperplasia and atypical hyperplasia in clinical diagnosis and treatment.Methods The immunohistochemiscal S-P method techniques were amplified to study the expression of aromatasecy P450, estrogen receptor （ER） and progesterone receptor （PR） in the tissues of endometrial from the observed group of 116 cases,including 30 cases of simple endometrial hyperplasia, 32 cases of complex endometrial hyperplasia and 54 cases of endometrial atypical hyperplasia and analysed the clinical processement of these cases.Results There was no the positive expression in the normal endometrial tissues.But the positive expressions of aromatasecy P450 were found in the tissues of endometrial hyperplasia （simple endometrial hyperplasia, complex endometrial hyperplasia and atypical hyperplasia）.The rates of the positive expressions were 41.1% ,46.1% and 73.2% respectively.There were significant relationships among fouth groups （x^2=46.69,P〈0.01）.There were no relationship between the rates of the positive expressions of ER and PR and degree of the histological atypia.There were no relationship between the expressions rates of aromatasecy P450 and the expressions of ER and PR in endometrial hyperplasia （simple endometrial hyperplasia,complex endometrial hyperplasia and atypical hyperplasia.）.Conelusion Aromatasecy P450 may be a factor that induces endometrial hyperplasia and carcinomatous changes.And it may become a biological marker in early carcinomatous changes in endometrial tissues.It indicates that the occurrence of endometrial hyperplasia had a relationship with estrogen stimulation in endometrium.The positive expressions of PR may be a prognostic factor in conservative treatmeat of endometrial hyperplasia.