米非司酮对子宫肌瘤血管内皮生长因子(VEGF)的影响

The effects of mifepristone on the expression of VEGF in hysteromyoma

目的探讨米非司酮对子宫肌瘤组织血管内皮生长因子(VEGF)的影响。方法选择40例手术治疗子宫肌瘤患者为肌瘤样本来源,随机分为对照组与米非司酮组各20例,米非司酮组术前口服米非司酮10mg/d,连服3个月,B超监测子宫及肌瘤体积变化;对照组术前3个月不服任何药物。术后用免疫组化SP法测定两组子宫肌瘤组织VEGF的表达。结果B超显示服药后子宫平均体积为235.4cm3,比用药前的327.4cm3缩小了28.1%,有非常显著性差异(P<0.001);服药后子宫最大肌瘤的平均体积为76.3cm3,比用药前的135.6cm3缩小了43.7%,有极显著性差异(P<0.001)。免疫组化结果显示,米非司酮组子宫肌瘤组织VEGF表达强度为(-)11例,(+)6例,(++)2例,(+++)1例,阳性率45%;对照组VEGF表达强度为(-)7例,(+)2例,(++)8例,(+++)3例,阳性率65%。米非司酮组VEGF表达强度低于对照组,差异具有显著性(0.01<P<0.025)。结论米非司酮可通过抑制子宫平滑肌瘤中VEGF的表达,具有一定的抗肿瘤血管生成作用。

Obective： To study the effects of mifepristone on the expression of vascular endothelial growth factor （VEGF） . Methods： 40 patients who need surgery were divided into two groups. One was control group who underwent surgery without any medicine pretreatment ; the other was mifepristone group who underwent surgery after pretreatment with mifepristone 10 mg/d for 3 months and the volume of uterine and leiomyoma was examined by B ultrasound. After surgery, the expression of VEGF in leiomyoma was investigated by immunohistochemieal techniques. Results： Among the 40 patients with leiomyoma who need surgery, the expression of VEGF in mifepristone group was： （ - ） 11 patients, （ ＋ ） 6 patients, （ ＋ ＋ ） 2 patients and （ ＋ ＋ ＋ ） 1 patient and the positive expression rate of VEGF was 45% ; the expression of VEGF in control group was： （ - ） 7 patients, （ ＋ ） 2 patients, （ ＋ ＋ ） 8 patients and （ ＋ ＋ ＋ ） 3 patients and the positive expression rate of VEGF was 65%. The mifepriston group had significantly lower expression of VEGF than the control group （0. 01 〈 P〈0. 025 ） . Conclusion： Mifepriston maybe inhibit the expression of VEGF in hysteromyoma.