内源性雌孕激素及其受体与宫颈癌的关系  

Association between endogenous hormones, hormone receptors and cervical cancer

作　　者：王金桃[1] 高尔生[2] 丁玲[1] 程玉英[3] 闫建文[4] 

机构地区：[1]山西医科大学流行病学教研室,太原030001 [2]上海市计划生育科研所 [3]山西省肿瘤医院妇科 [4]山西省肿瘤医院检验科

出　　处：《中华肿瘤杂志》2006年第7期494-497,共4页Chinese Journal of Oncology

基　　金：山西省科技攻关项目(021080)

摘　　要：目的探讨内源性雌、孕激素水平及其受体与宫颈癌发生的关系。方法采用病例对照研究方法,对141例宫颈癌患者、137例子宫肌瘤患者和129名健康妇女,用酶链免疫吸咐试验(ELISA)测定血清中雌二醇(E2)与孕酮(P)的含量,按照sABC免疫组化操作步骤进行宫颈组织中雌激素受体(ER)和孕激素受体(PR)的检测。结果宫颈癌组E2和P含量中位数分别为41．90 ng/ml和0．80 ng/ml,均明显高于两对照组,无论绝经与否,E2与宫颈癌的关联性均有统计学意义,并呈剂量反应关系,其归因危险度百分比(ARP)达89％以上。而以卵泡期正常参考值的下限浓度(2 pg/ml)为界进行定性分析,P与宫颈癌之间在绝经前后均无相关关系。宫颈癌组ER和PR的阳性率均低于子宫肌瘤组,但差异无统计学意义。结论内源性雌、孕激素的升高与宫颈癌的发生均有明显相关关系,特别是E2升高宫颈癌患病的风险更大,且不受绝经因素的影响,ER、PR对宫颈癌的发生可能具有一定的保护意义。Objective To explore the relationship between the levels of estrogen （E2 ） and progestogen（P）, expression of estrogen receptor （ER） and progesterone receptor （PR） and cervical cancer. Methods A case-control study with hospital and community controls was employed. The levels of serum estrogen and progesterone were detected by enzyme linked immunosorbent assay （ELISA） for 141 cervical cancer cases, 137 uterine myoma patients as controls and 129 health women as controls. ER and PR were measured by immunohistochemistry sABC in cervix tissues from patients with cervical cancer and uterus myoma as well. Results The levels of estrogen （47.49 ng/mL） and progesterone （2.34 pg/mL） in cases were significantly higher than those in both control groups. The association between estrogen and cervical cancer was significant both before and after menopause-adjusted, with over 89% of attributable risk percentage （ARP）, and showed a dose-response relation. Using the lowest value of 2 pg/ml in follicular phase as cut off point for progesterone, there were no statistically significant difference between cases and controls, and neither in progesterone nor in premenopausal. The expressions of ER and PR in cases were lower than those in controls, even after being menopause-adjusted. Conclusion The high level of endogenous estrogen and progestogen might increase the risk of cervical cancer. Compared with progestogen, estrogen showed a higher risk that was not influenced by menopause. In some sense, ER and PR may exert certain protective effect on progressing of cervical carcinogenesis.

关 键 词：宫颈肿瘤 雌激素 孕激素 激素受体 

分 类 号：R737.33[医药卫生—肿瘤]