大剂量米非司酮对绝经后子宫内膜息肉的雌、孕激素受体及Ki-67、Bcl-2的影响

Effect of large dose mifepristone on the expression of estrogen receptors,progesterone receptors,Bcl-2 and Ki-67 in postmenopausal endometrial polyps

目的:通过检测米非司酮(RU486)治疗绝经后子宫内膜息肉(EP)前后的雌、孕激素受体(ER、PR)及Ki-67、Bcl-2水平变化,探讨子宫内膜息肉的药物治疗方法。方法:绝经后子宫内膜息肉患者458例,均接受宫腔镜下子宫内膜息肉切除术(TCRP),术后病理诊断均为子宫内膜息肉,并采用免疫组化法检测子宫内膜息肉中雌、孕激素受体及Ki-67、Bcl-2的表达;随访以上患者,术后3个月～3年复发160例(经宫腔镜检查),均予大剂量米非司酮口服治疗,3个月后行宫腔镜检查,有残余息肉者55例,再行TCRP,并采用免疫组化法检测子宫内膜息肉中雌、孕激素受体及Ki-67、Bcl-2的表达。结果:米非司酮治疗复发子宫内膜息肉160例,105例EP消失,55例EP缩小,子宫内膜息肉中雌、孕激素受体及Ki-67的表达均较服药前明显降低,而Bcl-2变化不大。结论:大剂量米非司酮通过降调子宫内膜息肉中雌、孕激素受体及Ki-67的表达而有效治疗子宫内膜息肉。

Objective：To explore the expression of estrogen receptors（ER）,progesterone receptors（PR）,Bel-2 and Ki-67 in postmenopausal endometrial polyps before and after the treatment by large dose mifepristone （RU486）.Methods： 458 post-menopausal endometrial polyps were all treated by transcervical recection of polyp（TCRP）,and diagnosed by pathology.The presence of ER,PR, Bel-2 and Ki-67 were detected by immunohistochemical staining.Following up these cases, 160 cases reeured in three months to three years after treatment.These recurrence were treated by large dose mifepristone .After three months, 55 cases remainder EP were detected by hysteroseopy and treated by TCRP, then detected the presence of above receptors in the same way.Results： Among the 160 recurrence EP treated by RU486,105 cases were disappeared and 55 cases contracted.The presence of ER,PR and Ki-67 were obviously depressed,and Bel-2 had no significantly change. Conclusion： Large dose mifepristone can treat the utily EP by lowering the presence of ER,PR and Ki-67.