米非司酮治疗子宫肌瘤不同疗效者血管内皮生长因子表达差异的初步研究

Research on the Different VEGF Expression in Uterus Tumor Patients with Different Healing Effect of Mifepristone

目的:探讨米非司酮治疗子宫肌瘤疗效为何不同的分子生物学原因。方法:选择60例至少有一个瘤体≥3 cm的子宫肌瘤患者,于月经第5天服用米非司酮20 mg,每日1次,共3个月,服药前后测定血清血管内皮生长因子(VEGF),彩色多普勒超声检测肌瘤大小。服药后40例手术治疗,以肌瘤缩减≥2 cm和<2 cm分为A、B两组,在A、B两组中各随机选择10例为A1、B1两组,用免疫组化S-P法,对A、B两组瘤体组织及A1、B1两组瘤体旁开0.5 cm处平滑肌组织中VEGF表达和微血管密度(MVD)进行半定量分析。结果:服用米非司酮后血清VEGF下降幅度与肌瘤缩减呈正相关性,治疗前后相比差异有非常显著性(P<0.01);缩减明显与不明显两组相比,差异有显著性(P<0.05)。瘤体组织及旁开平滑肌组织中VEGF表达及MVD计数显示:A、B两组差异有显著性(P<0.05),A1、B1两组差异也有显著性(P<0.05)。结论:米非司酮治疗子宫肌瘤疗效不同的因素之一是药物对VEGF的降调作用不同所致。

Objective. To explore the molecular biological cause of mifepdstone＇s different healing effect on hysteromyoma. Methods. 60 patients with hysteromyoma size≥3 cm took mifepristone on the 5th day of their menstruation, 20 mg per day for 3 months, Serum VEGF ware measured before and after the imply of mifepdstone, tumor sizes ware measured by color doppler. According to the shrinking scale of the tumor （ ≥2 cm or 〈 2 cm）, the patients were divided into group A and group B, Then, 10 cases ware randomly chosen from each group as group A1 and group B1. VEGF expression and MVD ware semi- ration analyzed, not only from the tumor- bodies of group A and group B, but also from smooth muscle tissue 0.5 cm away from tumor - bodies of group A1 and group B1, with the method of immune histochmistry S - P method. Results：The falling range of serum VEGF level positively correlated to the shrinking level of the tumor after taking mifepdstone. VEGF expression daseased significantly after treatment. There was also noticeable difference between group A and group B, P 〈 0.01. The VEGF expression and MVD had significant difference between group A and group B, P 〈 0.05; as wall as between group A1 and group B1, P〈 0.05.Conclusions：One of the causes for different healing effect of mifepdstone on hysteromyoma may resulte from mifepdstone＇s different effect on VEGF.