米非司酮对子宫肌瘤、内膜组织ER、PR、bcl-2、bax的影响

Effects of mifepristone on expressions of ER,PR,bcl-2 and bax in endometrium and hysteromyoma

目的观察米非司酮治疗子宫肌瘤的效果及对子宫内膜的影响。方法子宫肌瘤患者(对照组)20例及经米非司酮治疗的子宫肌瘤患者(治疗组)30例术中均取瘤体及内膜,采用免疫组化SP方法检测肌瘤和内膜组织中雌、孕激素受体ER、PR和凋亡基因bcl-2、bax的表达。结果服米非司酮后,PR在肌瘤和内膜组织的阳性表达率明显下降(P<0.05),ER的阳性表达率变化不大(P>0.05);bcl-2在肌瘤组织的阳性表达率无变化(P>0.05),在内膜组织的阳性表达率明显下降(P<0.05);bax在肌瘤组织的阳性表达率明显上升(P<0.05),在内膜组织的阳性表达率无差别(P>0.05)。米非司酮治疗后内膜83.3%(25/30)表现为增生期改变,其中32%(8/25)为简单增生过长。结论米非司酮能促进子宫肌瘤细胞凋亡,同时又可能促进子宫内膜的增生。

Objective To study the effects of mifepristone on endometrium after treatment of hysteromyoma with mifepristone. Methotis The expressiom of ER, PR, bcl- 2, and bax in both endometrium and hysteromyoma in control group （ n = 20）, and treatment group （ n = 30） were detected by immunohistochemical S- P method. Results After mifepristone treatment of hysteromyoma, the positive rates of PR expressions in hysteromyoma and endometrium in treatment group decw, ased （ P 〈 0.05）,whereas the positive rates of ER expressions in hysteromyoma and endometrium in treatment group were not different from those in control group （ P 〉0.05）.The positive rate of bcl- 2 expression in edometrium in mifepristone group was fower than in control group with statistically significant difference. Whereas there was no signitlcant difference in hysteromyoma between the two groups before and after mifepristone treatment. Compared with control group, the positive rate of bax expression in hysteromyoma increased in mifepfistone group（ P 〈 0.05）, but it did not differ in endometrium between the two groups （ P 〉 0.05）. 83.3 % （25/30） of patients in mifepfistone group showed changes of proliferative phase in the endomeffium; among them,32% （ 8/25 ） showed simple hyperplasia. Condusiom Mifepristone promotes apoptosis of hysteromyoma cells, and probably contributes to proliferation of endometrium.