男性乳腺发育和乳腺癌与血清E2和ER及PR关系的临床研究

Clinical study on the relationship between the levels of E2, ER, PR and gynecomastia, male breast cancer

目的:研究男性乳腺发育、乳腺癌与雌激素水平、雌激素受体(ER)及孕激素受体(PR)之间的关系,探讨男性乳腺发育、乳腺癌患者病因及其临床治疗。方法:用放射免疫检测法测定了35例男性乳腺发育和20例正常献血员血清雌二醇(E2)、睾酮(T);用免疫组织化学SP法测定了35例男性乳腺发育、8例乳腺癌患者乳腺切除标本的ER和PR。结果:男性乳腺发育患者血清E2明显高于正常对照组(P=0·023),而T值两组差异无统计学意义;男性乳腺发育(77·1%、71·4%)、乳腺癌患者(87·5%、75·0%)病理标本ER、PR阳性率均较高。结论:男性乳腺发育、乳腺癌与体内E2水平及乳腺ER、PR相关,可能是机体环境中较高的雌激素及其相关激素一起与局部乳腺ER、PR相互作用,诱发男性乳腺发育,进而可能发展为乳腺癌;ER阻滞剂及降低雌激素水平的芳香化酶抑制剂可用于临床治疗男性乳腺发育和乳腺癌。

OBJECTIVE： To explore the etiological factor and clinical therapy for gynecomastia and male breast cancer （MBC）. METHODS： E2 and testosterone in serum of 35 gyne comastia patients and 20 healthy volunteers were measured by the way of radioimmunity. ER and PR in the breast ductal epithelium of the 35 gynecomastia patients and 7 MBC were measured immunohistochemically by the labelled streptavidin biotin. RESULTS： E2 levels were significantly different between gyne comastia patients and normal volunteers, but the testosterone levels in serum were not significantly different between the two groups. The positive rat were 77. 1% and 71.4% MBC were 87.5% and 7 of ER and PR in the gynecomastia the positive rates of ER and PR in 0%. CONCLUSIONS： Gynecomastia and MBC are related to the levels of E2,ER and PR, indicating that high E2 level in serum and high positive rates of ER and PR in breast tissue might promote the development of gynaecomstia and MBC. ER blocker and aromatizing-enzyme blocker which can decrease the estrogen level can be used in the treatment of gynecomastia and MBC.