乳腺肿瘤内分泌激素动态变化及治疗相关性研究

The research of dynamic change and relativity of hormone secretion breast tumor

目的寻找乳腺癌、乳腺增生患者内分泌激素变化共同规律。方法1252例乳腺肿瘤分5组统计：加权法统计分析433和111例乳腺肿瘤的激素平均值与正常人群标准值比较;53例（滤泡期）和15例（绝经期）乳腺肿瘤治疗前、后,两组统计（x±s）对照下丘脑-垂体激素;乳腺癌和乳腺增生病各50例,在治疗前绝经前期和绝经期,用秩和检验,正态近似法（Wilcox-on两样比较法）统计分析;按百分率统计分析440例乳腺肿瘤激素轴系相关性;按百分率统计分析1252例乳腺肿瘤伴随多种腺体疾病。结果乳腺肿瘤433和111例比正常人群滤泡期和绝经期HPO轴系的正常值增高;53例（滤泡期）和15例（绝经期）乳腺肿瘤治疗前、后,两组统计对照下丘脑-垂体激素,呈亢进的激素水平明显下调;100例乳腺良、恶性绝经前期FSH和绝经期ACTH高于乳腺异常增生病患者;分析乳腺肿瘤440例的HPO激素轴系、GH轴系、PRL激素轴系和免疫激素轴（ACTH轴系、TSH轴系）的相关性;总数滤泡期973例乳腺肿瘤中,40%伴随多种腺体疾病。结论乳腺增生病、乳腺癌患者,雌激素轴系（FSH、E2）长期处于绝对过高,刺激乳腺导管上皮增生、导管扩张及刺激靶受体（ER）增多,ER活性随着乳腺癌分化程度的降低而降低,其激素变化与病理改变过程相一致;乳腺癌患者绝经前期血浆中FSH和绝经期ACTH浓度高于乳腺增生病患者;乳腺肿瘤患者往往并发多种腺体疾病;其治疗前、后的亢进激素水平明显下调。

Objective Using statistics demonstration, the author tries to find common rule of hormone secretion and explain the contraction of hypothalamic pituitary hormone secretion pre - care and after - care, Methods A total number of 1252 mastopathy cases were divided into 4 groups. The average of 433 and 111 mastopathy cases was analysed by the weighted method, hypothalamic pituitary hormone secretion of 53 Mammary Cancer in the period of follicle and 15 mammary cancer in menopausal period was contracted between pre - care and after - care sufferer. 50 Mammary Cancer cases and 50 Hyperplasia of Mammary Glands cases in premenopausal and menopausal period was analyzed by Kruskal - Wallis （ Wilcoxon method ）. The relativity of 440 mammary cancer sufferer incretion is analyzed percentage Statistic. 1252mammary cancer sufferer is accompanied by many gland illnesses by percentage statistic. Results The HPO axes of 433 and 111 mammary glands patients are higher than those of normal people during the follicle and climacteric. TO compare 53 mammary cancer patients during the period of follicle and 15 mammary cancer patients during climacteric before and after the treatment, we find that comparing the thalamencephalon - pituitary hormone of two groups of statistic data, the level of hormone which appears sthenic is obvious lower; the FSH during the prophase of climacteric and the ACTH during the climacteric of 100 patients who suffer benign mammary cancer and malign mammary cancer are higher than those of the patients who suffer abnormal hyperplasia of mammary glands; We analyze the relevance among HPO hormone axes,GE axes,PRL hormone axes and immunity hormone axes （ ACTH axes ,TSH axes） of 440 mammary cancer patients ; Statistics demonstrate that 40 percent of 973 mammary cancer patients also suffer various glands diseases. Conclusion Regardless of benign or malign, the hormone secretion of abnormal hyperplasia of mammary glands patients and mammary cancer patients vary, and estrogen axes （FSH ,E2） are absolutely high for a long time, and then stimulate the mammary vessel epidermis hyperplasia, the vessel expend and stimulate the ER increase, the activity of ER decrease along with the de- creasing of mammary cancer differentiation degree, the transformation of hormone and pathology vary is accordant ; The FSH and ACTH in the blood plasma during the prophase of climacteric is higher than hyperplasia of mammary glands. Mammary cancer sufferer is accompanied by many gland illnesses. Hormone secretion of mammary cancer in pre - care and after - care is lowered obviousely.