摘要
目的:研究孕激素治疗前后子宫内膜增生组织中PTEN基因、bcl-2/Bax的表达,结合临床治疗效果探讨其在预测孕激素治疗反应中的作用。方法:回顾分析子宫内膜增生患者56例(复杂性增生31例,非典型性增生25例),孕激素治疗3个月,留取治疗前后子宫内膜组织,取石蜡切片进行免疫组化染色,应用H-score评价孕激素治疗前后子宫内膜腺体中PTEN、bcl-2/Bax的表达。结果:(1)56例患者治疗3个月后,44例(78.57%)缓解,7例(12.50%)有效,1例(1.79%)治疗后复发,4例(7.14%)治疗无效,平均随访(33.49±9.62)个月。复杂性增生、轻度非典型性增生和中重度非典型性增生3组缓解+有效率的差异无统计学意义(P=0.245)。(2)子宫内膜增生组织中PTEN基因表达缺失率为16.07%(9/56),PTEN表达阳性组缓解+有效率为97.87%(46/47),PTEN表达阴性组缓解+有效率为55.56%(5/9),两组间比较差异有统计学意义(P<0.05)。(3)56例患者孕激素治疗前后子宫内膜腺体中bcl-2及Bax表达均阳性。缓解和有效组与复发和无效组治疗前bcl-2/Bax的H-score值无明显差异(P=0.486),两组治疗前后H-score差值亦无明显差异(P=0.368)。结论:子宫内膜增生组织中PTEN基因表达阳性组对孕激素治疗反应较好,PTEN基因表达缺失可能提示病变对孕激素抵抗,因此治疗前检测子宫内膜腺体细胞中PTEN基因的表达可以预测疗效;bcl-2/Bax不能作为预测孕激素治疗反应的指标。
Objective:To study the expression of PTEN,bcl-2/Bax in endometrial hyperplasia with progestine therapy,and explore its predicting effect of progestine therapy.Methods:The clinical and pathological characteristics of 56 patients diagnosed with endometrial hyperplasia(31 of complex hyperplasia and 25 of atypical hyperplasia)were studied respectively.The expressions of PTEN,bcl-2 and Bax in endometrial glands of paraffin-embedded endometrial hyperplasia specimens were evaluated by immunohistochemistry technique.Results:(1)Among 56 cases,44 cases(78.57%)were resoluted,7 cases(12.50%)were regressed,1(1.79%)case was recurred and 4 cases(7.14%)were invalid.The follow-up average time was(33.49±9.62)months.Among complex hyperplasia,simple atypical hyperplasia and complex atypical hyperplasia,resolution and regression ratio had no difference(P=0.245).(2)Before treatment,PTEN expression were negative in 9/56 cases(16.07%).Resolution and regression ratio was 5/9(55.56%) in negative groups and 46/47(97.87%)in positive groups,with significant difference(P0.05).(3)bcl-2 and Bax were positive in all samples.Both the H-score value before treatment and the different value of H-score before and after treatment had no difference between resoluted/regressed groups and recurred/invalid groups.Conclusions:The response to progestine in PTEN positive groups is better than negative groups.PTEN-loss might indicate resisting to progestin.Detecting PTEN in endometrial glands before treatment might predict effect of progestin.bcl-2/Bax would not be a predictor of response to progestin therapy.
出处
《现代妇产科进展》
CSCD
2012年第4期271-274,279,共5页
Progress in Obstetrics and Gynecology
基金
北京市卫生局青年科学基金资助(No:QN2007-19)