雌激素靶器官肿瘤组织雌激素受体表达与术后下肢深静脉血栓形成的关系

Clinical study on the relationship between ER expression intensity and deep venous thrombosis of lower extremity after operation of estrogen target organ tumor

目的探讨雌激素靶器官肿瘤雌激素受体(estrogen receptor,ER)表达强度与术后下肢深静脉血栓形成(deep vein thrombosis,DVT)的关系。方法选取2013年5月—2016年5月接受手术治疗的子宫内膜癌患者20例(观察1组)、乳腺癌患者20例(观察2组),均于术后2周内出现下肢DVT。另选取年龄相匹配而未发生DVT的子宫内膜癌(对照1组)及乳腺癌患者(对照2组)各20例。收集各组病历资料,包括术前血清雌二醇(E_2)、术前BMI、手术时间、制动时间、术中失血量、ER蛋白阳性细胞百分比。免疫组化法检测肿瘤组织中ER蛋白表达。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组与对应的对照组术前血清E2、手术时间、制动时间、术中出血量比较差异无统计学意义(均P>0.05)。单因素分析显示,雌激素靶器官肿瘤术后下肢DVT的影响因素为手术时间、制动时间、术中出血量、ER表达强度和BMI(均P<0.05)。结论雌激素靶器官肿瘤组织ER呈高表达,ER是下肢DVT的危险因素。

Objective To investigate the relationship between the expression of estrogen receptor （estrogen）, ER （receptor） and DVT （deep vein） in the target organ of estrogen. Methods From May 2013 to May 2016, 20 patients with endometrial cancer who underwent surgical treatment （observation 1 group） and breast cancer patients （observation 2 group） were selected in the study. All patients were followed up for 2 weeks after surgery in DVT group. In addition, 20 cases of endometrial carcinoma （controll group） and breast cancer （control2 group） withou DVT were selected. The data of each group were collected, including preoperative serum estradiol （E2）, preoperative BMI, operation time, breaking time, intraoperative blood loss, percentage of ER positive cells. Immunohistochemical method was used to detect the expression of ER protein in tumor tissues. Measurement data uses t test,and count data uses 2＂2 test, P〈0.05 is considered statistically significant.Results The expression !ntensity of ER in breast cancer tissues was significantly higher than that in the control group, the difference between the two groups was statistically significant （P〈0.05）. BMI of the observation group was significantly higher than that of the control group （P〈0.05）. The expression intensity of ER in endometrial carcinoma tissues showed that the expression of ER in endometrial tissue of the observation group was significantly higher than that of the control group （P〈0.05）. BMI of the observation group was significantly higher than that of the control group （P〈0.05）. Univariate analysis showed that the irfiluencing factors of postoperative DVT in patients with estrogen target organ tumors were operation time, braking time, intraoperative blood loss, ER expression intensity and BMI （all P〈0.05）. Conclusion ER is highly expressed in tumor tissues of estrogen target organs, and ER is a risk factor for DVT.