口服大剂量MPA对子宫内膜癌血管生成的影响

Effect of orally administered high dose medroxyprogesterone acetate on angiogenesis in en-dometrial carcinoma.

目的:探讨口服大剂量醋酸甲羟孕酮(MPA)对子宫内膜癌间质血管生成的影响。方法:选择经诊断性刮宫证实、未经任何治疗的子宫内膜癌20例,术前口服MPA55mg/d,连续10d。用免疫组化法(LSAB法)以CD34标记血管内皮细胞计数微血管密度(MVD),同时测定用药前后内膜癌标本中PR、VEGF、bFGF的表达,VEGF和bFGF采用计算机图象分析进行半定量分析,比较其用药前后在内膜癌中表达的变化。结果:用药后内膜癌中PR、bFGF的表达及MVD均明显低于用药前,差异有显著性(P<0.05),而用药前后VEGF的表达差异无显著性(P=0.09)。用药前后的内膜癌标本中VEGF和bFGF的表达均与MVD呈正相关(P<0.05)。结论:口服MPA能显著抑制内膜癌间质中的血管生成,其作用可能是通过调节bFGF而不是VEGF的表达实现的。

Objective: To evaluate the effect of orally administered medroxyprogesterone acetate (MPA) upon angiogenesis in the stroma of endometrial carcinoma.Methods:Twenty untreated endometrial carcinoma patients diagnosed through dilation and curettage of the uteri were given high dose of MPA (500mg/d) for 10d prior to hysterectomy. All specimens of pre- and post-MPA administration were stained immunohistochemically (LSAB method) for CD34 as a sensitive and specific marker for vascular endothelium. The mean microvessel density (MVD) per high power field was calculated. Protein expression of PR(specify) ,VEGF(specify) and bFGF (specify) were evaluated for all specimens by immunohistochemistry simultaneously. VEGF and bFGF levels were analysised by computer with the OPTTMAS software to detect the mean light density (mARLIGH). Results: Im-munoreactivity of PR, bFGF and MVD in post-treatment specimens were significantly less than those; of pre-treatment ones (P<0.05) .There was no significant difference of VEGF immunostaining between pre and post MPA treatment(P=0.09) .The expression levels of VEGF and bFGF were correlated linearly with MVD, in both pre and post-MPA treatment specimens(P<0.05). Conclusions: Orally administration of MPA demonstrates significant antiangiogenic effect on the stroma of the endometrial carcinoma. Regulation of bFGF, but not VEGF is the mechanism by which MPA exerts its antiangiogenic effect on endometrial carcinoma.