免疫组化法测定小儿隐睾睾丸周围组织AR,ER的意义

Androgen and Estrogen Receptors Expressions Detected by Immunochemistry Method(SP) in Paratesticular Tissues of Children with Cryptorchidism

目的 探讨隐睾患儿睾丸周围组织中雄激素受体 (AR)和雌激素受体 (ER)的分布及临床意义。方法 隐睾组患儿共 3 9例 ,其中单侧隐睾 2 6例 ,双侧 13例 ,取隐睾睾丸周围组织 (鞘状突、提睾肌、睾丸引带、阴囊皮肤 ) ,对照组共 2 9例 ,取同期手术的小儿斜疝及鞘膜积液的上述相应部位组织 (阴囊皮肤除外 ) ,包埋石蜡切片 ,免疫组化法 (SP)测定AR、ER阳性率。结果 隐睾组患儿鞘膜及睾丸引带AR阳性率低于对照组 (P <0 .0 5 ) ,单侧隐睾组患儿鞘膜及睾丸引带AR和ER阳性率高于双侧组 (P <0 .0 5 )。隐睾组患儿鞘膜ER阳性率低于对照组 (P <0 .0 5 ) ,阴囊皮肤中AR阳性率在四种组织中最高 ,不同年龄阶段的阴囊皮肤中AR阳性率存在差别 (P <0 .0 5 ) ,以 3～ 6岁年龄段阳性率居高。结论 隐睾组患儿在睾丸周围组织鞘膜及睾丸引带中AR表达率低于正常儿 ,而ER在鞘突中的阳性表达率高于正常儿 ,这表明隐睾患儿睾丸周围组织中AR的低下为隐睾的特点 ,可考虑为其病因之一 ,而ER的异常尚不能考虑构成为隐睾的病因。双侧隐睾鞘膜和引带中AR和ER阳性表达低于单侧隐睾 ,可能是双侧隐睾患儿雄性化程度较差的因素。阴囊皮肤中的AR的表达明显高于其它三种睾丸周围组织 ,在 3～ 6岁年龄段易于表达。

Objective To investigate androgen and estrogen receptor expressions in paratesticular tissues of children with cryptorchidism and their significance.Methods 39 children with cryptorchidism were contained in one group,including 26 unilateral cases and 13 bilateral ones,with a contrast group of 29 cases of inguinal hernia and hydrocele in the same period.Biopsies of paratesticular tissues,including processus vaginalis,cremaster muscle,gubernaculum testis,and scrotum skin,were taken during operations,but scrotum skin was not obtained in the contrast group.Biopies were embeded in paraffin liquid and sliced up.The expressions of androgen and estrogen receptors were examined with immunochemistry(SP).Results The group of cryptorchidism,compared with the contrast group,had a lower AR expression in processus vaginalis and gubernaculum testis (P<0.05),and a lower ER expression in the processus vaginalis (P<0.05).The unilateral cases had a higher AR and ER expressions in processus vaginalis and gubernaculum testis than those of the bilateral cases (P<0.05).AR expression in the scrotum skin was the highest (P<0.05),with a peak at 3～6 years old.Conclusion AR and ER expressions in processus vaginalis and gubernaculum testis of children with cryptorchidism are quite different from those of contrast group ,which suggests that the abnormality of AR in paratesticular tissues could be considered a cause of cryptorchidism,while the abnormality of ER in the processus vaginalis might not be.Lack of male features in pudendum of the bilateral cases may be due to the low AR and ER expressions in processus vaginalis and gubernaculum testis.The expression of AR in the scrotum skin is the highest,not least in the bracket of 3 to 6 years old.