子宫肌瘤患者子宫静脉血泌乳素水平及组织中泌乳素受体相关性的研究

The Relationship Between Prolactin in Uterine Vein and Prolactin Receptor in Leiomyoma Tissue in Patients with Uterine Myoma

目的:探究子宫肌瘤的发生、发展与泌乳素的相关关系。方法:取月经增生期因子宫肌瘤来院要求手术的患者30例,B超测定子宫肌瘤的大小(3径a、b、c)及数目,在手术麻醉以前抽取上肢外周静脉血3ml,术中抽取子宫静脉血3ml,同时抽取非输液侧上肢静脉血3ml,分别测雌激素(E2)、孕激素(P)、泌乳素(PRL)的含量,术后取子宫肌瘤组织、肌层组织用免疫组化法测泌乳素受体(PRL-R)。结果:子宫肌瘤患者术中子宫静脉血PRL、E2较外周静脉血中升高(P<0.01),孕激素(P)差异无显著性;术中外周静脉血PRL较术前升高(P<0.01),E2、P差异无显著性;术中子宫静脉血中PRL水平与肌瘤体积呈正相关(r=0.431,P<0.05);在肌瘤组织、肌层组织及内膜组织中均发现有PRL-R表达,但肌瘤组织比肌层组织中有更强的表达(u=2.260P<0.05)。子宫静脉血中PRL水平与肌瘤组织中PRL-R呈正相关(r=0.643,P<0.01)。结论:PRL通过泌乳素受体促进肌瘤细胞的增殖,在子宫肌瘤的发生、发展中起了重要的作用。

Objective：To study the effects of prolactin（PRL） on pathenogesis of uterine leiomyoma and the relationship between prolactin and prolactin recepto（PRL-R） in myoma tissues. Methods： Thirty patients with uterine leiomyoma during prolifrative phase were studied. We recorded the number of the leiomyoma and scaned them in vedical,horizontal and oblique section to measure the size of the leiomyoma（a,b,c）with ultrasund. Blood sample from peripheral vein of and uterine vein and peripheral vein leiomyoma patients were colleced before hysteretomy and during hysterectomy. Serum prolactin（PRL） ,estradiol（E2） ,and progesterone（P） level were determined by radio iramuno assay. Immunohistochemical method was carded out to detect the expression of prolactin receptor（PRL-R） in myoma mytmetrial, and endometrial tissue. Results： The serum prolactin and E2 level of uterine vein was singnificantly higher than that of peripheral veins＇（ P 〈 0.05）. The prolactin levels in peripheral vein during hysterectomy was singnificantly higher than that before hysterectomy（ P〈0.01 ）.The prolactin level in uterine vein during surgery were positively correlated to the volume of leiomyoma （ r = 0.431, P 〈 0.05）. The expression of prolactin receptor were found in myoma, myometrial,and endome trial tissues.The positive rate of prolactin receptor in leiomyoma was higher than that in myometnum （ u = 2.260 P 〈 0.05）. The prolactin level of uterine veins was positively correlated to the expression of PRL-R in leiomyoma tissue（ r = 0.643, P 〈 0,01 ）. Conclusions： Prolactin is an autocrine or paracrine growth factor for human myometrial and leiomyoma cells.