米非司酮对子宫腺肌病组织中血小板源性生长因子表达及对月经的影响

Effects of mifepristone on expression of platelet-derived growth factor in adenomyosis tissues and menstruation

目的探讨米非司酮对子宫腺肌病患者在位内膜组织中血小板源性生长因子(PDGF)表达及对月经的影响的可能机制。方法 2006年1月至2011年8月在山西医科大学第一医院妇科因子宫腺肌病行子宫切除术者为研究组,因宫颈上皮内瘤变(CIN)Ⅲ行子宫切除术者为对照组,采用组织芯片和免疫组织化学SP法,检测试验组、对照组在位子宫内膜组织中PDGF的表达水平以及对月经的影响,并比较其差异。结果 PDGF主要表达在子宫内膜腺细胞胞质内,对照组(17%)与试验组在位内膜(37%)阳性率差异有统计学意义(P<0.05);PDGF阳性表达率用米非司酮干预组(27%)与未用米非司酮组(70%)之间差异有统计学意义(P<0.05);月经量改变与PDGF阳性表达率差异有统计学意义。小剂量米非司酮有抑制子宫出血的作用,无不良反应。结论 PDGF参与子宫腺肌病的发病过程;米非司酮对PDGF有抑制作用。PDGF在月经改变中可能起一定的作用。小剂量、短时间应用米非司酮可抑制子宫出血。

Objective To explore the effect of mifepristone on the expression of platelet-derived growth factor （PDGF） in eutopic endometrial tissues and potential mechanism of its impact on menstruation in patients with adeno myosis. Methods Patients who underwent hysterectomy as a result of adenomyosis in the department of gynecology, First Affiliated Hospital of Shanxi Medical University between January 2006 and August 2010 were allocated into the study group, and patients who received hysterectomy due to CINⅢ were assigned into control group. Expression of PGDF in endometrial tissues and its impact on menstruation were determined via tissue microarray and immunohisto chemical SP assay for comparison on the distinction between both groups. Results PDGF expression was found predominantly in the cytoplasm of endometrium. The positive expression rate of eutopic endometrium in study group （37%） was higher than that in control group （17%, P0.05）. Mifepristone resulted in lower PDGF expression （27% vs 70%, P0.05）. In addition, the distinction in menstrual changes and PDGF expression rate reached statistical significance. Low dose mifepristone was associated with inhibition of metrorrhagia. No adverse event was reported. Conclusion Mifepristone could result in inhibition of PDGF, which may be involved in the pathogenesis of adenomyosis and might play a role in changes of menstruation. Short-term low dose mifepristone may be administered to inhibit metrorrhagia.