性激素及其受体在食管癌高发区食管鳞癌发生发展过程中的作用  

Roles of Sex Hormones their Receptors in Carcinogenesis of Esophageal Squamous Cell Carcinoma from High-incidence Area of Esophageal Cancer

作　　者：王启鸣[1] 庄则豪[2] 李吉学[3] 李燕杰[3] 马智勇[1] 朱辉[1] 刘涛[1] 王慧娟[1] 王立东[4] 

机构地区：[1]河南省肿瘤医院 [2]福建医科大学第一附属医院,福建福州350004 [3]河南大学基础医学院,河南郑州475000 [4]郑州大学癌症研究室,河南郑州450052

出　　处：《中国肿瘤》2008年第7期618-621,共4页China Cancer

基　　金：国家杰出青年科学基金(30025016);2005年河南省医学科技攻关计划(92)

摘　　要：[目的]探讨性激素及其受体在高发区食管鳞癌发生、分化、转移中的作用。[方法]采用放射免疫法(RIA)检测食管癌高发区林州原发性食管鳞癌患者44例和林州当地以及食管癌低发区同龄健康体检者各60人的血清性激素水平;采用免疫组化法(ABC)测定72例青年食管鳞癌患者(≤40岁)的手术切除标本ER表达状况。[结果]男性低发区健康人组、高发区健康人组和患者的血清雌激素水平分别为70.500±11.300pg/ml、54.684±18.159pg/ml、42.330±16.016pg/ml,女性低发区健康人组、高发区健康人组和患者的血清雌激素水平分别为87.010±13.910pg/ml、52.044±21.790pg/ml、32.998±19.339pg/ml,低发区健康人组的血清雌激素水平高于高发区健康人组和患者(男性的P值均为<0.001,女性的P值分别为0.0183和<0.001);男性低发区健康人组、高发区健康人组和患者的血清雄激素水平分别为4.100±1.500ng/ml、5.485±2.485ng/ml、5.555±2.648ng/ml,女性低发区健康人组、高发区健康人组和患者的血清雄激素水平分别为0.618±0.076ng/ml、1.795±0.959ng/ml、1.985±0.990ng/ml,低发区健康人组的血清雄激素水平低于高发区健康人组和患者(男性的P值分别为0.0457和<0.001,女性的P值均为<0.001)。高发区青年食管鳞癌患者中,高、中、低分化者的ER阳性率分别为65%、54%、37%(P=0.0684),淋巴结有无转移者ER阳性率分别为44%、58%(P=0.3450),侵及黏膜下层—肌层和纤维膜者的ER阳性率分别为42%、53%(P=0.5368),TNM分期处于Ⅰ、Ⅱ期和Ⅲ期ER阳性率分别为66%和35%(P=0.0176)。[结论]食管癌高发区人群血清雌激素水平过低和雄激素水平过高及其比例改变可能是决定食管癌变和易感性的重要因素之一。结合性激素受体状态检测可能更有助于加深对性激素与食管鳞癌关系的认识。[Purpose] To explore roles of sex hormones and their receptors in the occusion, differentiation and metastasis of esophageal squamous cell careinoma（ESCC） from high-incidence area（HIA） for esophageal cancer. [Methods] RIA was used to determine serum sex hormone levels of patients with ESCC from HIA（n=44） and age-matched asymptomatic population from low-incidence area （LIA）（n=60） and HIA（n=60）. Seventy-two specimens of young ESCC patients （≤40 years old） collected from HIA hospital were analyzed for ER expression by immunohistochemistry for ER. [Results] Serum estradiol levels of male asymptomatic population from LIA, male asymptomatic population from HIA and male ESCC patients from HIA were 70.500±11.300pg/ml, 54.684±18.159pg/ml, 42.330±16.016pg/ml, respectively; serum estradiol levels of female asymptomatic population from LIA, female asymptomatic population from HIA and female ESCC patients from HIA were 87.010±13.910pg/ml, 52.044±21.790pg/ml, 32.998±19.339pg/ml,respec- tively; serum estradiol level of asymptomatic population from LIA was significantly higher than those in asymptomatic population from HIA and ESCC patients from HIA（P values of male were 〈0.001,〈0.001, respectively, P values of female were 0.0183, 〈0.001, respectively）. Serum testosterone levels of male asymptomatic population from LIA , male asymptomatic population from HIA and male ESCC patients from HIA were 4.100±1.500ng/ml, 5.485±2.485ng/ml, 5.555±2.648ng/ml, respectively; serum testosterone levels of female asymptomatic population from LIA, female asymptomatic population from HIA and female ESCC patients from HIA were 0.618± 0.076ng/ml, 1.795±0.959ng/ml, 1.985±0.990ng/ml, respectively; serum testosterone level of asymptomatic population from LIA was lower than those in asymptomatic population from HIA and ESCC patients from HIA（P values of male were 0.0457, 〈0.001, respectively, P values of female were 〈0.001,〈0.001, respectively）. In the young ESCC patients, the expressions of

关 键 词：食管鳞癌 性激素 血清 睾酮 雌二醇 雌激素受体 河南 

分 类 号：R735.1[医药卫生—肿瘤]