子宫内膜ER、PR表达在宫腔粘连治疗预后的分析  

Implication of Endometrial ER and PR Expression for the Prognosis of Intrauterine Adhesions

作　　者：龚月宾 程丹[1] 周丽 闫文杰[1] 袁静萍[3] 高利昆[3] 杨菁[1] GONG Yuebin;CHENG Dan;ZHOU Li;YAN Wenjie;YUAN Jingping;GAO Likun;YANG Jing(Reproductive Center, Wuhan People＇ s Hospital;Hanchuan People＇ s Hospital, Wuhan University, J Wuhan People＇ s Hospital Pathology Department, Wuhan University, Wuhan, 430060, China;Hanchuan, Hubei, 431600, China Wuhan, 430060, China)

机构地区：[1]武汉大学人民医院生殖中心,武汉市430060 [2]武汉大学汉川市人民医院妇产科,湖北省汉川市431600 [3]武汉大学人民医院病理科,武汉市430060

出　　处：《医学分子生物学杂志》2018年第3期161-165,共5页Journal of Medical Molecular Biology

基　　金：国家自然科学基金（No.81401276,81771662）

摘　　要：目的应用免疫组化的方法对临床诊断为官腔粘连患者的子宫内膜雌激素受体（estrogen recep-tor，ER）、孕激素受体（progesterone receptor，PR）表达进行半定量分析，探讨其对宫腔粘连治疗预后的意义。方法收集2016年12月至2017年8月在武汉大学人民医院生殖中心因临床诊断为“宫腔粘连”行宫腔镜检的患者224例．手术中留取子宫内膜标本。通过免疫组化SP法测定子宫内膜腺体与间质ER、PR表达。①收集52例经官腔镜诊断为正常宫腔形态的病例子宫内膜标本，分析子宫内膜腺体与间质中ER、PR的表达规律以及表达水平与年龄、孕产次等因素的相关性。②选取子宫内膜标本172例。根据美国生殖学会（AFS）评分标准按粘连程度分：无粘连52例，轻度粘连40例，中度粘连37例，重度粘连43例。对比不同组别病例子宫内膜ER、PR表达水平．分析官腔粘连程度和子宫内膜ER、PR表达的相关性。③选取15例同一例官腔粘连患者两次官腔镜检的子宫内膜标本，比较治疗前后的子宫内膜ER、PR表达改变。从3方面联合分析子宫内膜ER、PR表达在宫腔粘连治疗预后的作用。结果①子宫内膜ER表达与PR表达水平呈正相关。子宫内膜腺体、间质ER与PR表达水平均相关（P〈0．001）。②子宫内膜腺体ER、PR表达较间质ER、PR表达高。子宫内膜PR表达较ER高。子宫内膜腺体、间质ER与PR表达水平。比较均有差异（P〈0．01、P〈0．001）。③子宫内膜ER、PR表达与年龄、孕次不相关。④无粘连组和轻度粘连组与重度粘连组的子宫内膜腺体ER、PR表达水平均有差异（P〈0．05、P〈0．01）。其余各组组间无差别。⑤治疗前后子宫内膜ER、PR的表达无显著性差异。结论ER、PR在子宫内膜腺体与间质均表达，其中在腺体的表达高于间质，子宫内膜ER与PR有相同的表达趋势。子宫内膜腺体ER、PR表达水平与官腔粘�Objective The endometrial expression of estrogen receptor （ER） and progester-one receptor （PR） were semiquantitatively analyzed in patients with intrauterine adhesions by using immunohistochemistrv to explore their implication in the prognosis of intrauterine adhesions. Meth-ods Included in the study were 224 patients who had undergone hysteroscopy for clinical diagnosis of ＂ uterine cavity adhesion＂ from December 2016 to August 2017 in the Wuhan People＇ s Hospi-tal, of Wuhan University. Endometrial specimens were intraoperatively obtained and the SP method was used to detect the endometrial gland and stromal ER and PR expression. ① Fifty-two endometri-al specimens were collected from the uterine cavity hysteroscopically confirmed to be morphologically normal and examined for the expression of ER and PR in endometrial glands and interstitium, and the correlation between the expression levels and age, gravidity and parity and other factors. ② 172 endometrial specimens were selected. According to the criteria of the American Reproductive Society （AFS） , 52 had no adhesions; 40 had mild adhesions 37 had moderate adhesions and 43 had severe adhesions. The correlation between the severity of adhesion and ER and PR expressions were analyzed. ③ Fifteen specimens hysteroscopically collected from the same patients were compared in terms of the expression of ER and PR in the endometrium before and after treatment, Results ① ER expression was positively correlated with PR expression in endometrium. The expressions of ER and PR in endometrial glands and stroma were correlated （P 〈 0. 001) . ② The expression of ER and PR in endometrial glands was higher than in stroma. The expression of PR in endometrium was higher than in ER. The expression levels of ER and PR in endometrium were different （P 〈 0. 01, P 〈0. 001) . ③ The expression of ER and PE in endometrium was not correlated with age and ges-tational age. ④ The expression levels of ER and PR in endometrium of non-adhesion group, mi

关 键 词：宫腔粘连 宫腔镜 雌激素受体 孕激素受体 

分 类 号：R392.11[医药卫生—免疫学]