雌激素受体β与子宫内膜息肉发病关系的研究

Study on the relationship between estrogen receptor β and etiology of human endometrial polyps

目的探讨雌激素受体β(ERβ)与子宫内膜息肉(EP)发病的关系。方法采用免疫组化链霉菌抗生物素蛋白-过氧化物酶链接(SP)法,检测72例EP患者[其中36例合并不孕(不孕组),36例为带宫内节育器后发生EP(置器组)]的EP和正常子宫内膜组织ERβ、ERα含量[用吸光度(A)值表示],同时采用放射免疫法检测EP患者外周血中雌二醇浓度。结果(1)不孕组和置器组患者EP间质细胞中ERβ含量分别为2·1±0·9和1·9±0·5,明显高于两组同时期子宫内膜间质细胞中的含量(1·7±0·3,1·3±1·1),分别比较,差异均有统计学意义(P<0·05);(2)不孕组患者外周血和EP组织中雌二醇浓度分别为(66·4±12·8)pmol/L和(3·0±0·7)pmol/L,二者呈正相关关系(r=0·789,P<0·01);置器组患者外周血和EP组织中雌二醇浓度分别为(67·4±13·4)pmol/L和(2·8±0·7)pmol/L,二者也呈正相关关系(r=0·792,P<0·01)(3)EP中ERβ的含量与EP中雌二醇浓度呈正相关,且与外周血雌二醇浓度呈正相关;(4)两组ERα在EP间质细胞中的表达较其在相同时期的子宫内膜间质中的表达明显下降(P<0·05);且ERα含量与EP中雌二醇浓度无明显相关性,与外周血雌二醇浓度也无明显相关性。结论ERβ在子宫内膜间质细胞中的过度表达,可能是导致EP发病的原因之一。

Objective To investigate the relationships between the expression of estrogen receptor β （ERβ） and etiology of human endometrial polyps（EP）. Methods Thirty-six females with infertility and 36 females with intrauterine contraceptive device （IUD, aged from 23 years to 33 years, average 28 years ） were enrolled in the study. Blood samples were taken before hysteroscopy for analysis of the level of estradiol in serum. All the tissue samples of benign EP and endometrium in the same cycle were obtained through hysteroscopy on the 5th to 9th days of menstruation cycle（ all the women selected had the same menstrual period ）. Part of the samples of EP were made into homogenates to assay the level of estradiol, and the rest of EP and endometrium were both fixed with 10% formalin. If one of the samples was confirmed by histopathologic analysis, the correspondence was eligible. Otherwise, they were abnegated. Seventy-two samples were collected and 60 were eligible as a result. The expression of ER β and ERα in these samples was detected by immunohistochemical staining, while the levels of estradiol in both serum and homogenate of EP were detected by radioimmunoassay. Results The expression of stromal ERβ of EP in infertility and IUD groups （2. 1 ±0. 9,1.9 ±0. 5 ） was significantly higher than those of endometrium in the same cycle （ 1.7 ± 0. 3,1.3 ± 1.1 ） （ P 〈 0. 05 ） ,while the expression of stromal ERa of EP was significantly decreased than those of endometrium （P 〉 0. 05 ）. The expression of ERβ in glands had no difference in both EP and endometrium. The expression of ERβwas significantly positively related to the levels of estradiol in both serum and homogenate （ P 〈 0. 01 ）, while the expression of ERα had no correlation with estradiol. Conclusions Overexpression of ERβ in stroma might play an important role in the pathogenesis of EP.