异位内膜GnRH受体表达与GnRHa疗效的研究  

Expression of GnRH-R in ectopic endometrial tissue and investigate therapeutic effect of GnRHa on patients with EMS

作　　者：杜英 胡庆伟 黄国英 

机构地区：[1]湖州市妇幼保健院,313000

出　　处：《浙江医学》2006年第7期540-542,共3页Zhejiang Medical Journal

摘　　要：目的探讨子宫内膜异位症(EMS)患者在位子宫内膜和异位子宫内膜组织中促性腺激素释放激素受体(GnRH-R)的表达情况及其临床意义。方法采用免疫组化法检测40例正常子宫内膜组织及126例EMS患者在位子宫内膜和卵巢异位子宫内膜组织中GnRH-R的表达,同时对每位EMS患者术后应用3个月促性腺激素释放激素类似物(GnRHa),观察其卵巢内膜异位囊肿的复发情况。结果在位内膜100.00%表达GnRH-R,异位内膜组织有62.38%的GnRH-R表达,且EMS患者在位内膜组织GnRH-R的表达率明显高于异位内膜组织(P<0.01);Ⅱ、Ⅲ、Ⅳ期EMS患者异位内膜组织GnRH-R的表达率分别为84.6%、61.8%、37.5%,差异有显著性意义(χ2=13.43,P<0.05);GnRH-R阳性者的卵巢内膜异位囊肿的复发率(3.95%)低于GnRH-R阴性者(18.0%)(χ2=6.84,P<0.05)。结论异位内膜GnRH-R表达的缺失有可能与子宫内膜异位症的发生、发展有关;通过测定异位内膜GnRH受体的表达,有可能为临床EMS患者的治疗及疗效预测提供一定的参考依据。objective To investigate the expression of gonadotropin-releasing hormone receptor （GnRH-R ）in eutopic endometrial tissues and ovarian ectopic endometrial tissues of patients with endometriosis（EMS）, and the therapeutic effect of gonadotropin releasing hormone analogues （GnRHa） on patients with EMS. Methods Expression of in eutopic endometrial tissues and in ectopic endometrial tissues of 126 patients with EMS was detected by immunohistochemistry, GnRH-R in endometrial tissues of 40 normal female subjects was also measured. Patient with EMS received GnRHa （Diphereline） for 3 months after operation and the recurrence of endometrial cyst of ovaries was monitored by B-type ultrasonography. Results Immunohistochemistry showed that the expression of GnRH-R in eutopic endometrial tissues and in ectopic endometrial tissues was 100% and 62.4%（P〈0.01）. The expression rate of GnRH-R in ectopic endometrial tissues of patient with stage Ⅱ stage Ⅲ and stageⅣ was 84.6%, 61.8%, 37.5% （P〈0.05）. The recurrence of endometrial cyst after GnRHa therapy in patients with positive GnRH-R was significantly lower than that with negative GnRH-R （ 4.0% vs 18.0%, P〈0.05 ）. Conclusion Determination of GnRH-R expression in ectopic endometrial tissues of patients with EMS may be useful in guidance of endocrine therapy and efficacy prediction.

关 键 词：子宫内膜异位症 促性腺激素释放激素受体 促腺激素释放激素类似物 异位子宫内膜 

分 类 号：R711.71[医药卫生—妇产科学]