异常子宫出血患者子宫内膜中ER、PR分布情况研究

The basic search of the expression of ER and PR in different endometrial sites in the uterine cavity for patients with abnormal uterine bleeding(AUB)

目的观察异常子宫出血患者子宫内各部位内膜组织雌激素受体(estrogen receptor,ER)、孕激素受体(progestron receptor,PR)表达有无差异,为宫腔镜下子宫内膜电切术切除范围提供理论依据。方法门诊宫腔镜下观察异常子宫出血须诊刮及部分行子宫全切除术的患者宫腔内不同部位的子宫内膜组织,用免疫组织化学方法测定ER、PR含量,采用LeicaQ500IW图像分析仪进行测定,应用光密度值进行比较。结果异常子宫出血患者子宫腔内各部位内膜增生情况不同:ER、PR含量从高到低的顺序为:宫底>子宫体部>子宫角部>宫颈峡部;ER、PR在子宫腔内各部位分布情况的不同具有相关性。结论对于宫底部高ER、PR状态,要引起高度重视;经宫颈子宫内膜电切术(transcervical resection of endometrium,TCRE)或子宫内膜热球剥脱术(uterine balloon thermablate,UBT)。术中谨慎并彻底处理宫底与双侧宫角部的子宫内膜组织,破坏其内膜的结构,避免复发和恶化。

Objective To evaluate the expression of ER and PR in different endometrial sites in the uterine cavity for patients with abnormal uterine bleeding（AUB）so as to offer the theory for operation. Methods 30 cases of AUB from September 2003 to September 2004 were included in the study. Endometrial biopsy in different sites in the uterine cavity was performed,and ER and PR were measured in immunohistochemistry. Every patient had never been treated hormonally before. Secretary phase endometrium was approved by pathologic result. ER and PR staining index were determined with a computerized image analyzer. Results The expression of ER and PR of different endometrial sites in the uterine cavity for patients with AUB is different（P 〉0. 01）. Expression of ER and PR fundus of uterus is the highest,while isthmus of cervix is the lowest. The trend of ER and PR is fundus of uterus 〉 corpus uteri 〉 isthmus of cervix. Expression of PR in endometrial different sites is correlated with ER. Conclusion More attention should be paid to the high expression of ER and PR in fundus of uterus. Careful and thoroughly resection andometrium of fundus and isthmus of cervix are necessary.