聚焦超声消融治疗对乳腺纤维瘤患者雌激素受体和孕激素受体的影响

Effects of focused ultrasound ablation on estrogen receptor and progesterone receptor in patients with breast fibroma

目的探讨聚焦超声消融治疗对乳腺纤维瘤患者雌激素受体(ER)和孕激素受体(PR)的影响。方法选择2018年8月至2020年8月我院治疗的84例乳腺纤维瘤患者,采用随机数字表法将其分为对照组与观察组,各42例。对照组采用经乳晕切口手术治疗,观察组采用聚焦超声消融治疗。比较两组患者治疗前、后的ER、PR表达、性激素水平、心理状态、生活质量、血清基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平;比较两组患者的自主活动恢复时间、住院时间及视觉模拟评分法(VAS)评分。结果治疗后,两组患者的ER、PR表达水平均降低,且观察组低于对照组(P<0.05)。治疗后,两组患者的P、E2水平均降低,且观察组低于对照组(P<0.05)。治疗后,两组患者的HAMD评分均降低,SF-36评分均升高,且观察组均优于对照组(P<0.05)。观察组患者的自主活动恢复时间、住院时间均短于对照组,VAS评分低于对照组(P<0.05)。治疗后,两组患者的MMP-9、VEGF水平均降低,且观察组低于对照组(P<0.05)。结论聚焦超声消融治疗应用于乳腺纤维瘤患者中安全可靠,有利于降低ER、PR表达,改善患者性激素水平,降低MMP-9、VEGF水平,减轻患者负性情绪,提高生活质量,促进术后恢复,可作为乳腺纤维瘤的有效治疗方法。

Objective To investigate the effects of focused ultrasound ablation on estrogen receptor(ER)and progesterone receptor(PR)in patients with breast fibroma.Methods A total of 84 patients with breast fibroma treated in our hospital from August 2018 to August 2020 were selected,and the patients were divided into control group and observation group by random number table method,with 42 cases in each group.The control group was treated with operation through areola incision,and the observation group was treated with focused ultrasound ablation.The expression of ER and PR,level of sex hormone,psychological state,quality of life,levels of serum matrix metalloproteinase-9(MMP-9)and vascular endothelial growth factor(VEGF)were compared between the two groups before and after treatment;the recovery time of autonomic activities,hospital stay and visual analogue scale(VAS)score were compared between the two groups.Results After treatment,the expression levels of ER and PR in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).After treatment,the levels of P and E2 in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).After treatment,the HAMD score in the two groups decreased,and SF-36 score in the two groups increased,and those in the observation group were better than the control group(P<0.05).The recovery time of independent activities and hospital stay in the observation group were shorter than those in the control group,and the VAS score was lower than that in the control group(P<0.05).After treatment,the levels of MMP-9 and VEGF in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).Conclusion The focused ultrasound ablation applied in patients with breast fibroma is safe and reliable,it is conducive to reduce the expression of ER and PR,improve the levels of sex hormone,reduce the levels of MMP-9 and VEGF,relieve the negative emotion of patients,improve the quality of life and promote postoperative recovery,which can be used as an effective treatment for breast fibroma.