核分裂率与增殖细胞核抗原指数在监测给予雌、孕激素后大鼠子宫内膜变化中的作用

Application of Mitotic Index and Proliferating Cell Nuclear Antigen Index in Monitoring the Change of Rat Endometrium after Administration of Estrogen and Progestin

目的探讨核分裂率（ MI）和增殖细胞核抗原（ PCNA）指数在监测不同剂量雌、孕激素作用不同时间后，大鼠子宫内膜的增殖与抑制变化中的作用。方法选择去势后 SD大鼠作为动物模型，模拟临床雌、孕激素的连续与周期给药方案。分别在给药不同时间后，检测大鼠子宫内膜的 MI与 PCNA指数的变化。结果 PCNA指数可敏感反映不同剂量雌激素作用不同时间对大鼠子宫内膜的增殖作用，同时也反映不同剂量孕激素作用不同时间对大鼠子宫内膜增殖的抑制作用。 MI可反映雌激素对子宫内膜的增殖作用，但在反映孕激素的抑制作用时不敏感。结论 PCNA指数在反映雌、孕激素对子宫内膜的作用时优于 MI。

To investigate the mitotic index(MI) and proliferating cell nuclear antigen (PCNA) index in monitoring the rat endometrium during estrogen and progestin administration. Methods One hundred and sixty Sprague- Dolly rats were randomly divided into seven groups. The 1st and 2nd group were normal estrous (E) and ovariectmized (OVX) control . The other groups received estradiol (E2V) only or combined with medroxyprogesterone(MPA) which imitated the clinical regimen in different dosage and different time before sacrificed . Uteri sections were stained with HE and immunohistochemical procedures to detect mitosis and PCNA. Results The MI and PCNA index were similar in the luminal and glandular cells. Both markers were low in the two control groups and increased with the E2V dosage in the treatment group. But if E2V was given for 1 to 21 days, the MI increased during the first 3 days and then dropped to low level and kept to the end. PCNA index increased in the first 3 days and decreased to a low level on the 4th day and then increased gradually to a high level until the last day. In the continuous regimen, both markers decreased as the MPA dosage increased. In the cyclic regimen, The MI reached to a significant low level nearly to zero in almost each ratio. Addition of MPA for 10 days, PCNA index at the ratio of 1∶ 4.0 could be reduced to a low level and addition for 5 days, PCNA index in each subgroup was still as high as the positive control even though the dosage of MPA increased several times to 1∶ 8.0. Conclusions This study suggests that PCNA index can reflect both the effect of estrogen and progestogen. PCNA index is better than mitotic index in reflecting the change of endometrium.