绝经后子宫肌瘤中芳香化酶P450的表达及意义

Expression of Aromatase Cytochrome P450 in Postmenopausal Uterine Leiomyoma

目的:探讨芳香化酶P450(P450arom)在绝经后子宫肌瘤中的表达及其在子宫肌瘤发病中的作用。方法:选取100例子宫肌瘤患者,其中绝经后非萎缩性组40例,绝经后萎缩性组20例,绝经前增生期组20例,分泌期组20例。术前测定血清中雌二醇(E2)含量,术中取肌瘤及其相应肌层组织作免疫组织化学染色,检测P450arom的表达。结果:绝经后非萎缩性组与萎缩性组两组血清E2含量相比,差异无统计学意义(P>0.05)。P450arom在绝经后非萎缩性组、增生期及分泌期组肌瘤中的表达水平相比,差异无统计学意义(P>0.05),但均显著高于其相应肌层组织及绝经后萎缩性组(P<0.01);而P450arom在绝经后萎缩性组中的肌瘤表达水平与相应肌层组织相当,差异无统计学意义(P>0.05)。结论:P450arom在绝经后非萎缩性肌瘤中过度表达,可能导致雌激素原位合成增加,使其不萎缩或继续生长。

Objective： To investigate the expression of aromatase cytochrome P450 （P450arom） in postmenopausal uterine leiomyoma and the role of P450arom in the pathogenesis of uterine leiomyoma. Methods： 100 cases of leiomyoma in different menstrual situation were examined P450arom by immunohistochemical technique, including 40 cases with symptomatic postmenopausal uterine leiomyoma,20 cases with regressive postmenopausal uterine leiomyoma, 20 cases of proliferative phase and 20 cases of secretory phase of premenopausal uterine leiornyoma. Serum estradiol （E2） was determined by chemiluminescence immunoassay before operation.Flesults： Serum E2 level was no statistically significant difference between symptomatic postmenopausal uterine leiomyoma and regressive postmenopausal uterine leiomyoma （ P 〉 0.05 ）. There was no difference in P450arom expression among symptomatic postmenopausal uterine leiomyoma, premenopausal proliferative and secretory uterine leiomyoma （ P 〉 0.05）, higher than the corresponding myometrium and regressive postmenopausal uterine leiomyorna （P 〈 0.01 ）; Therefore, there was no obvious difference in P450arom expression between regressive postmenopausal utedne leiomyoma and its corresponding myornetrium （ P 〉 0.05）. Conclusions： The over-expression of P450arom in symptomatic postmenopausal uterine leiomyoma may result synthesize estrogen in situ and keep in uterine leiomyoma growth or no reduction.