雌激素受体与胰腺癌生物学行为的关系及内分泌治疗的临床观察

Estrogen receptor expression and its relationship with biologic behavior of pancreatic carcinoma

目的 探讨雌激素受体 (ER)与胰腺癌生物学行为的关系及内分泌治疗的效果。方法 经大体和显微镜检查了 5 7例胰腺癌的病理特征 ,观察了术后生存期 ,并用单克隆抗体检测nm2 3 H1、p2 1ras和增殖细胞核抗原 (PCN)的表达与ER的关系。 17例病人予以长期服用他莫昔芬 (TAM) 30mg/d治疗。结果 雌激素受体阳性的胰腺癌分化程度较好 ,低浸润、术后生存期长 ,其构成比高于ER阴性胰腺癌 ,P <0 0 5 ;ER阳性胰腺癌p2 1ras和PCNA的表达低于阴性者 ,P <0 0 5 ;nm2 3 H1的表达高于阴性者 ,P <0 0 1。ER(+)者TAM治疗后效果优于ER(- )者 ,改善了生存率。结论 雌激素受体阳性胰腺癌具有较好的生物学行为和预后 。

Objective To understand the relationship between the clinico pathologic significance of estrogen receptor (ER) and biological behavior of pancreatic carcinoma. Methods ER was detected in 57 pancreatic carcinoma patients with immunohistochemistry. Some pathologic characteristics such as differentiation, invasion and metastasis, and expression of some genes—p21ras, nm23 H1 and PCNA were observed. Seventeen out of the 57 patients were subjected to long term treatment with 30 mg/d TAM. Results ER positive carcinoma had better differentiation, less invasion and longer survival time as compared to ER negative one (P<0 05). The percentages of positive expression of PCNA and p21ras in ER positive pancreatic carcinoma were lower than those in ER negative one, while the positive expression of nm23 H1 in ER positive carcinoma was higher than that in ER negative one. Patients with ER(+) and treated with TAM had a longer survival duration. Conclusion The results suggest that ER positive pancreatic carcinoma has less malignant biologic behavior and better prognosis than ER negative one does. TAM therapy is beneficial to the survival time of pancreatic carcinoma patients.