左炔诺孕酮宫内缓释系统对子宫内膜息肉电切术后IGF-Ⅰ和IGF-ⅠR表达的影响

The effect of levonorgestrel-releasing intrauterine system on IGF-Ⅰ and IGF-ⅠR expression after transcervical resection of polyp

目的探讨左炔诺孕酮宫内缓释系统(LNG-IUS)对子宫内膜息肉电切术(TCRP)术后患者子宫内膜组织胰岛素样生长因子-I(IGF-I)及其受体(IGF-IR)表达的影响。方法选取100例子宫内膜息肉(EP)患者,对照组(n=50)仅给予TCRP治疗,观察组(n=50) TCRP术后给予LNGIUS治疗。比较两组患者月经失血图(PBCA)评分、子宫内膜厚度、术后复发率、子宫内膜组织IGF-I和IGF-IR mRNA表达水平。结果术后1、3、6、12个月,观察组PBAC评分、子宫内膜厚度均显著小于对照组(P <0. 05)。术后12个月,观察组子宫内膜组织IGF-I和IGF-IR mRNA表达水平均显著低于对照组(P <0. 05)。术后随访12个月,对照组和观察组复发率分别为16. 0%(8/50)、4. 0%(2/50),观察组术后复发率显著低于对照组(P <0. 05)。结论 TCRP术后联合LNG-IUS治疗可明显降低EP复发,而下调IGF-I及IGF-IR mRNA表达是其可能作用机制。

Objective To evaluate the effect of levonorgestrel-releasing intrauterine system (LNG- IUS)on insulin-like growth factor-I (IGF-I)and insulin-like growth factor-I receptor (IGF-IR)expression after transcervical resection of polyp (TCRP).Methods 100 cases of endometrial polyps were selected. The control group (n =50)was treated with TCRP only,while the observation group (n =50)was treated with LNG-IUS after TCRP.The scores of pictorial blood loss assessment chart (PBCA),endometrial thick- ness,recurrence rate,mRNA expression of IGF-I and IGF-IR in endometrial tissue were compared between the two groups.Results At 1,3,6,12 months follow-up,the PBAC score and endometrial thickness of observation group were significantly lower than control group (P <0.05).At 12 months after operation,the mRNA expression levels of IGF-I and IGF-IR in the endometrium of the observation group were significantly lower than those of the control group (P <0.05).After 12 months of follow-up,the recurrence rates of the control group and the observation group were 16.0%(8/50)and 4.0%(2/50),respectively.The recurrence rate of the observation group was significantly lower than that of the control group (P <0.05).Conclusions TCRP combined with LNG-IUS treatment can significantly reduce EP recurrence,and down-regulation of the mRNA expression of IGF-I and IGF-IR maybe its possible mechanism.