糖皮质激素治疗敏感型血管瘤患儿各期瘤组织中糖皮质激素受体亚型的表达

Expressions of glucocorticoid receptor subtypes in tumor tissues of children with sensitive hemangioma during different stages treated by glucocorticoid

目的:探讨糖皮质激素治疗敏感型血管瘤患儿各期瘤组织中糖皮质激素受体(GR)亚型α、β蛋白的表达。方法:选择同意接受糖皮质激素治疗的血管瘤患儿56例作为研究对象,根据治疗效果筛选出41例激素治疗敏感型患儿,按照病理检测分为增生期12例、消退期17例和完全退化期12例;同期入院接受手术的非血管瘤患儿10例作为对照组,治疗前、后均细针穿刺取小块皮肤组织。采用酶联免疫法和免疫组织化学法检测4组患儿皮肤组织中GRα、GRβ的蛋白含量及蛋白阳性表达强度。结果:治疗前与对照组比较,增生期、消退期和完全退化期GRα的蛋白含量及蛋白阳性表达强度均明显增高且依次的减弱,各组间比较差异有统计学意义(P<0.01);GRβ的蛋白含量及蛋白阳性表达强度各组比较差异无统计学意义(P>0.05)。治疗后增生期、消退期和完全退化期GRα的蛋白含量及蛋白阳性表达强度均明显降低且依次的减弱,各组比较差异无统计学意义(P>0.05);GRβ的蛋白含量及蛋白阳性表达强度与治疗前比较差异亦无统计学意义(P>0.05)。结论:激素敏感型的血管瘤患儿能通过下调瘤组织中的GRα的蛋白含量及蛋白阳性表达强度,从而抑制血管瘤的增殖及促进其消退,其疗效与GRβ的调控无关。

ObJective： To explore the expressions of glucocorticoid receptor （GR） subtypes （oL protein, 13 protein） in tumor tissues of children with sensitive hemangioma of different stages treated by glueoeorticoid. Methods： Fifty-six children with hemangioma were selected and treated by glucocorticoid in the hospital, 41 children with sensitive hemangioma were screened out according to curative effect, then they were divided into proliferative stage （12 children）, resolution stage （17 children）, and complete degradation stage （12 children） according to pathological examination. Ten Children without hemangioma were selected as control group, then they underwent surgery during the same period in the hospital. Fine-needle aspiration was conducted before and after treatment to obtain small pieces of skin tissue. ELISA and immunohistochemistry were used to detect the contents and positive expression levels of GRct protein and GR13 protein in skin tissues of children in the four group. Results： Before treatment, compared with control group, the contents and positive expression levels of GRot protein in skin tissues of children with sensitive hemangioma during prolifexative stage, resolution stage, and complete degradation stage increased significantly and weakened in sequence, there were statistically significant differences among different groups （P〈O. O1 ） ; there was no statistically significant difference in the content and positive expression level of GR[3 among different groups （P〉 O. 05 ） . After treatment, the contents and positive expression levels of GRot protein in skin tissues of children with sensitive hemangioma during proliferative stage, resolution stage, and complete degradation stage decreased significantly and weakened in sequence, there was no statistically significant difference among different groups （P〉0. 05 ）; there was no statistically significant difference in the content and positive expression level of GR13 compared with before treatment （P〉O. 05 ） . Conclusion： The content and positive expression level of GRct protein are down-regnlated in the children with sensitive hemangioma, then proliferation of hemangioma is inhibited and the resolution of hemangioma is promoted, the curative effect is not correlated with regulation of GRβ.