射频消融对子宫肌瘤组织病理变化及雌、孕激素受体表达的影响  

Pathological changes and changes of ER, PR expression in uterine leiomyoma tissue with radiofrequency ablation

作　　者：宋雯霞[1] 罗新[1] 吴秀枝[1] 常明伟[1] 

机构地区：[1]武汉大学人民医院妇产科,湖北武汉430060

出　　处：《郧阳医学院学报》2002年第5期257-260,共4页Journal of Yunyang Medical College

摘　　要：目的 :观察射频治疗子宫肌瘤后组织的病理改变和雌孕激素受体 (ER、PR)表达的情况 ,探讨射频治疗子宫肌瘤的机制。方法 :30例多发性子宫肌瘤患者 ,分别采用 0 .5cm、1.2cm长的射频刀行射频治疗 ,2 8例治疗后立即切除子宫 ,2例 3d后切除子宫 ,于消融灶中心 (A组 )、边缘 (B组 )、边缘外 1cm(C组 )、边缘外 2cm(D组 )处取材 ,HE染色下观察病理变化 ,免疫组化检测ER、PR水平 ;选同一患者子宫上未做射频治疗的肌瘤作为对照组。结果 :射频治疗后 ,消融灶中心肌瘤组织呈凝固性坏死 ,ER、PR无表达 ;消融灶边缘肌瘤细胞变性 ,ER、PR表达减少 (P <0 .0 5 ) ;消融灶边缘外 1cm ,肌瘤细胞无变性、坏死 ,但ER、PR表达仍低于对照组 (P <0 .0 5 ) ;消融灶边缘外2cm ,ER、PR与对照组相比差异无显著性 (P >0 .0 5 )。结论 :使肌瘤组织凝固性坏死 ,ER、PR低表达是射频治疗子宫肌瘤的机制之一。Objectives To observe the pathological features and expression of estrogen receptor(ER) and progestin receptor (PR) in human uterine leiomyoma after radiofrequency ablation(RFA) in order to find out its mechanism.Methods 30 patients with uterine leiomyoma were treated with 0.5 cm or 1.2 cm long RFA electrodes . Hysterectomy was performed in 28 cases just when the RFA treatment finished and in 2 patients after 3 days of RFA treatment. Specimens were obtained from the center tissue of ablation(group A), marginal tissue of the ablation(group B), tissues of 1cm far from the margin (group C), and tissues of 2cm far from the margin(group D) for immunohistochemical ER and PR analyses. All of the specimens were stained with hematoxylin-eosion for pathologic examination. Specimens obtained from untreated leiomyoma in the same uterine served as control group.Results Pathologic section of a leiomyoma RFA lesion reveals a sharply demarcated area of coagulative necrosis.There was no expression of ER and PR in group A. ER and PR optical density in group B and group C was significantly less than that of control group( P <0.05), but that of group D is similar to control group( P >0.05).Conclusions It is an important mechanism that RFA inducing coagulative necrosis and the lower expression of ER and PR in hysteromyoma could treat uterine leiomyoma.

关 键 词：射频消融 子宫肌瘤 病理学 雌激素受体 孕酮受体 治疗 

分 类 号：R737.33[医药卫生—肿瘤]