子宫肌瘤与肌肉组织雌孕激素受体含量与月经周期及子 …

应用放射受体分析法测定４０例子宫肌瘤患者子宫肌瘤、肌肉组织雌激素受体（ＥＲ）、孕激素受体（ＰＲ）的含量，月经周期根据月经史经子宫内膜组织相来判断，比较两种组织ＥＲ、ＰＲ含量与月经周期及子宫内膜组织相的关系。结果：子宫肌瘤组织的ＥＲ、ＰＲ含量高于同一子宫正常肌层的含量（Ｐ〈０．０５）；子宫肌瘤与肌肉两种组织中ＥＲ含量在子宫内膜增殖期高于分泌期（Ｐ〈０．０２５，Ｐ〈０．０５），ＰＲ含量分泌期高于增殖期     

黄体功能缺陷与子宫内膜效应不良患者的内分泌特征

目的：分析比较黄体功能缺陷（ＬＰＤ）和子宫内膜效应不良（ＩＥＲ）患者的内分泌特征。方法：采用放射免疫法和放射性配体饱和竞争、葡聚糖活性碳吸附分析法，测定ＬＰＤ、ＩＥＲ患者和月经周期正常者（对照组）的血清激素水平及同一月经周期子宫内膜组织中的雌、孕激素受体含量。结果：ＬＰＤ患者黄体期的雌、孕激素水平显著低于对照组（Ｐ＜０．００１），其子宫内膜雌、孕激素受体含量在整个月经周期中与对照组无差异（Ｐ＞０．１）；而ＩＥＲ患者整个月经周期的血清雌激素水平均低于对照组（Ｐ＜０．００１），但黄体期的血清孕激素水平与对照组无差异（Ｐ＞０．１），子宫内膜增生期的胞浆雌激素受体、胞核孕激素受体和整个月经周期的胞浆孕激素受体含量亦显著低于对照组（Ｐ＜０．００１，Ｐ＜０．００１，Ｐ＜０．０５）。结论：ＬＰＤ和ＩＥＲ是内分泌特征根本不同的两种情况，ＬＰＤ主要表现为黄体细胞分泌雌、孕激素功能下降，子宫内膜相应受体含量正常；ＩＥＲ则为整个周期的雌激素水平降低及相应受体合成障碍，而黄体分泌孕激素的功能正常。     

子宫肌瘤组织雌、孕激素受体及细胞增殖相关抗原与激素及细胞核体关系的探讨

应用ＡＢＣ法和计算机图象分析系统（ＩＡＳ），定量分析３９例子宫肌瘤患者子宫组织雌激素受体（ＥＲ）、孕激素受体（ＰＲ）、细胞增殖相关抗原（Ｋ１ｉ－６７）的含量；对其中２２例应用放射免疫法测定血浆雌二醇（Ｅ＿２）、孕酮（Ｐ）、促黄体素（ＬＨ）、促卵泡素（ＦＳＨ）含量；以及对其中８例应用立体学方法进行细胞核体定量分析。结果：子宫肌瘤组的ＥＲ、ＰＲ、Ｋｉ－６７显著高于同一子宫正常肌层的含量（Ｐ＜０．０１）；子宫肌瘤的细胞核体数密度和体密度也显著高于同一子宫正常肌层的对应值（Ｐ＜０．０５，Ｐ＜０．０１）；子宫肌瘤的ＥＲ、ＰＲ与血浆的Ｅ＿２、Ｐ含量无明显相关性，而与ＬＨ、ＦＳＨ含量呈负相关（Ｐ＜０．０５）；Ｋｉ－６７与Ｐ呈正相关（Ｐ＜０．０５）；子宫肌瘤的ＥＲ与其细胞核体数密度呈正相关（Ｐ＜０．０５）。提示：子宫肌瘤的发生、发展与雌、孕激素、ＬＨ、ＦＳＨ及其受体含量有关，孕激素在肿瘤发生、发展中可能起协同作用。     

多囊卵巢综合征患者子宫内膜病理改变及雌,孕激素受体测定

目的观察多囊卵巢卵巢综合征（ＰＣＯＳ）患者子宫内膜病理改变及雌激素受体（ＥＲ）、孕激素受体（ＰＲ）改变。方法对３９例ＰＣＯＳ患者进行子宫内膜病理检查,采用免疫组化方法测定子宫内膜ＥＲ及ＰＲ,并以正常妇女作为对照。结果３４例（８７．２％）ＰＣＯＳ患者子宫内膜呈无排卵型,内膜增殖症发生率为５１．３％（２０／３９）,内膜腺体发育不同步为３５．９％（１４／３９）,内膜间质反应不良为４６．２％（１８／３９）。ＰＣＯＳ患者子宫内膜增殖期ＥＲ、ＰＲ较正常妇女增多（Ｐ＜０．０５）,内膜增殖症者间质ＰＲ减少（Ｐ＜０．０５）且分布不均匀。结论ＰＣＯＳ患者子宫内膜的病理改变和局部ＥＲ、ＰＲ减少或缺乏,可能是不孕的原因之一。     

子宫内膜异位症患者内膜雌,孕激素受体测定及口服棉酚后的变化

采用葡聚糖活性碳吸附法，对２７例正常生育妇女（对照组）及２４例子宫内膜异位症患者（Ｅｍ组），测定了宫腔内膜雌激素胞浆受体（ＥＲｃ）、孕激素胞浆受体（ＰＲｃ）浓度。并测定Ｅｍ组中１５例口服醋酸棉酚２个月后，月经周期同日测定ＥＲｃ及ＰＲｃ浓度；同时对１６例手术切除的子宫、附件标本的原位内膜与异位内膜的ＥＲｃ、ＰＲｃ浓度进行比较。结果：对照组子宫内膜ＥＲｃ、ＰＲｃ浓度呈周期性变化，以卵泡晚期最高，黄体中期显著下降（Ｐ＜０．０５），黄体晚期进一步降低。Ｅｍ组原位内膜ＥＲｃ、ＰＲｃ浓度及周期性波动与对照组无差异，但异位内膜ＥＲｃ、ＰＲｃ浓度显著低于原位内膜（Ｐ各＝０．００３６及＜０．０００１），且失去周期性变化。口服棉酚２个月后血清雌二醇、孕酮浓度无显著下降，４例（２６．７％）患者子宫内膜组织相显示腺体分泌减少，但原位内膜ＥＲｃ、ＰＲｃ浓度却已显著降低（Ｐ＝０．０２１７及０．０１）。本研究提示：异位内膜与原位内膜对内源性性激素反应的不同步现象与异位内膜雌、孕激素受体浓度低下有关；棉酚对原位内膜ＥＲｃ、ＰＲｃ浓度的早期抑制现象，并不依赖于对卵巢功能的抑制作用，这一作用途径应对异位内膜同样有效。     

重复性早期自然流产病人非孕期血清激素水平和子宫内膜组织ER、PR含量变化的研究

用放免法测定了４０例拟诊为由内分泌病因所致的重复性早期自然流产病人卵泡期和黄体期的血清雌二醇（Ｅ２）、孕酮（Ｐ）、卵泡刺激素（ＦＳＨ）、促黄体生成素（ＬＨ）和血清催乳素（ＰＲＬ）水平，同时用生化法测定了相应增生期和分泌期子宫内膜组织中胞浆及胞核的雌、孕激素受体含量。通过和对照组比较，发现重复性早期自然流产病人黄体期和卵泡期的Ｅ２水平均显著低于对照组（Ｐ＜０．００５和Ｐ＜０．０５），其余各项激素水平与对照组无差异（Ｐ＞０．０５）；其子宫内膜增生期的胞浆雌激素受体（ＥＲｃ）含量显著低于对照组（Ｐ＜０．００５），分泌期子宫内膜的胞浆孕激素受体（ＰＲｃ）含量亦明显低于对照组（Ｐ＜０．０５）；各期子宫内膜组织的胞核雌、孕激素受体含量在两组间无差异。表明卵巢雌激素分泌不足和子宫内膜组织的受体含量减低是导致该组病人反复自然流产的原因。     

子宫内膜异位症异位与在位内膜发育日期及雌,孕激素受体水平

目的：探讨子宫内膜异位症的发病机理，方法：对２８例子宫内膜异位症的在位内膜和异位内膜进行病理组织学发育日期评定，对其中１５例采用免疫组化ＡＢＣ法测定雌激素受体（ＥＲ）、孕激素受体（ＰＲ）水平，并进行比较。结果：异位内膜较在位内膜发育落后的有１９例（６７．９％），提前的４例（１４．３％）仅５例（１７．９％）相符合；ＥＲ、ＰＲ水平异位内膜罗在位内膜低，在腺体中的差别有显著性（Ｐ〈０．０１，Ｐ〈０．０５     

表皮生长因子受体在子宫内膜、早孕蜕膜及滋养细胞中的表达

目的了解表皮生长因子受体（ＥＧＦＲ）在子宫内膜细胞分化及发育中的作用。方法采用免疫组织化学及逆转录聚合酶链反应（ＲＴＰＣＲ）技术测定５８例正常子宫内膜（３２例增生期,２６例分泌期）与２６例早孕蜕膜。结果ＥＧＦＲ存在于正常子宫内膜、早孕蜕膜腺体及间质细胞的细胞膜、核膜及胞浆内,分布均匀。ＥＧＦＲ还位于早孕蜕膜腺体及间质细胞核内。正常子宫内膜ＥＧＦＲ的表达,腺体部分高于间质部分（Ｐ＜０．０５）,ＥＧＦＲ在增生期及分泌期子宫内膜腺体的表达差异无显著性（Ｐ＞０．０５）,但ＥＧＦＲ在早孕蜕膜组织中的表达明显高于增生期及分泌期（Ｐ＜０．０５）。ＥＧＦＲ在间质细胞的表达,早孕蜕膜高于分泌期内膜,而增生期内膜则表达最低（Ｐ＜０．０５）。ＥＧＦＲｍＲＮＡ的表达从弱到强依次为增生期、分泌期、蜕膜、滋养细胞,增生期与分泌期比较,差异无显著性（Ｐ＞０．０５）,早孕蜕膜较分泌期及增生期明显增加（Ｐ＜０．０５）,滋养细胞ＥＧＦＲｍＲＮＡ的表达明显高于增生期、分泌期及早孕蜕膜（Ｐ＜０．０５）。结论ＥＧＦＲ存在于各期子宫内膜中,其表达在正常月经周期中无明显变化,但在早孕蜕膜、滋养细胞中的表达明显高于增生期及分泌期内膜     

皮下埋植左旋18甲基炔诺酮对鼠子宫与卵巢雌,孕激素受体的影响

目的：观察皮下埋植左旋１８甲基炔诺酮（ＬＮＧ）对ＳＤ鼠子宫内膜与卵巢组织雌激素受体（ＥＲ）、孕激素受体（ＰＲ）含量的影响。方法：对４５只雌性、性成熟ＳＤ鼠分别行皮下埋植ＬＮＧ和普通硅胶管手术，于埋植后第１５天、３０天、４５天取ＳＤ鼠子宫内膜与卵巢组织采用饱和浓度单点法进行ＥＲ、ＰＲ含量测定，并与未埋植的同期ＳＤ鼠进行对照。结果：埋植ＬＮＧ后的ＳＤ鼠子宫内膜与卵巢组织ＥＲ、ＰＲ测定值，较同期对照组明显下降（Ｐ＜０．０１），并随皮埋时间延长而逐渐降低。结论：皮下埋植ＬＮＧ可减少ＳＤ鼠子宫内膜与卵巢组织ＥＲ、ＰＲ含量，并与其避孕机理及术后突破性出血有关。     

子宫内膜癌bcl-2癌基因的持续性表达及其临床意义

目的：研究子宫内膜癌ｂｃｌ－２癌基因的表达及其临床意义。方法：采用免疫组化ＡＢＣ法检测增生期、分泌期、单纯型增生、复合型增生及不典型增生子宫内膜共２６份，子宫内膜癌４９例的ｂｃｌ－２癌基因蛋白表达及雌、孕激素受体（ＥＲ、ＰＲ）的表达。结果：正常增生期子宫内膜、增生的子宫内膜存在ｂｃｌ－２的表达，与ＥＲ相关，分泌期子宫内膜ｂｃｌ－２表达下降；４９例子宫内膜癌中２６例ｂｃｌ－２表达阳性，占５３％，２９例ＥＲ表达阳性，占５９％，２５例ＰＲ表达阳性，占５１％。７２％ｂｃｌ－２表达阳性者ＥＲ阳性，７５％ｂｃｌ－２表达阴性者ＥＲ阴性（Ｐ＜０．０１）。６８％ｂｃｌ－２表达阳性者ＰＲ阳性，６２％ｂｃｌ－２阴性者ＰＲ阴性（Ｐ＜０．０５）。子宫内膜癌Ｇ１、Ｇ２级ｂｃｌ－２的表达率为６６％，显著高于Ｇ３级者（２１％）（Ｐ＜０．０５）。ｂｃｌ－２的表达与肌层浸润、手术分期无关，ｂｃｌ－２表达阳性及阴性者生存率统计差异无显著性。结论：子宫内膜ｂｃｌ－２的持续性表达与卵巢激素相互作用可能在子宫内膜癌发生、发展中起作用     

Estrogen and progesterone receptors in leiomyomas and normal uterine tissues during reproductive life

Estrogen and progesterone receptors (ER, PR) were measured in leiomyomas and normal uterine tissues. Estrogen receptors concentration was higher in endometrium than in leiomyomas, lowest in normal myometrium. In the case of progesterone receptors, the concentrations in endometrium and leiomyomas were similar whereas that of myometrium was lower. ER and PR concentration were similar in leiomyomas of the uterine fundus, body and isthmus and steroid receptor content in the inner parts of large myomas was the same as in the outer parts. ER and PR concentrations in tumor-bearing myometrium were not different from those in myometrium of a control group.     

育龄期功能失调性子宫出血患者子宫内膜组织中雌、孕激素及其受体的变化与意义

目的:研究育龄期功能失调性子宫出血患者子宫内膜组织中雌、孕激素及其受体的变化。方法:随机采集2005年8月至2006年11月北方学院附属第一医院妇产科门诊育龄期功血35例患者的静脉血及子宫内膜功能层组织为研究组,以20例月经正常健康女性排卵后期标本为对照组。(1)采用放免法测定研究组及对照组血清及子宫内膜组织中雌二醇(E2)、孕激素(P)的含量;(2)HE染色后对子宫内膜进行组织学诊断;(3)用TUNEL原位标记技术精确测定子宫内膜功能层细胞凋亡指数;(4)用免疫组化法检测子宫内膜中雌、孕激素受体(ER、PR)的表达。结果:育龄期功血患者以排卵型为主(30/35),其子宫内膜组织中E2含量高于对照组(P<0.05),而P含量低于对照组(排卵后期的子宫内膜),二者差异有统计学意义(P<0.05);两组血清中E2、P差异无统计学意义(P>0.05),但血清、子宫内膜中E2和P呈正相关(rE2=0.74,PE2<0.01;rP=0.65PP<0.01);育龄期功血患者子宫内膜中ER、PR表达及凋亡指数较对照组显著增高,差异有统计学意义(P<0.01)。结论:育龄期功血绝大多数可能系体内作用于子宫内膜的雌、孕激素产生的时间、数量及其受体比例失衡所致,细胞凋亡也参与了功血的发生。     

不孕症子宫内膜息肉雌激素受体和孕激素受体表达的研究

目的:探讨不孕妇女子宫内膜息肉中雌激素受体(ER)和孕激素受体(PR)的表达及意义。方法:选择2009年9月至2010年4月在广东省计划生育专科医院就诊伴发子宫内膜息肉的50例不孕妇女(EP组)作为研究组,同期就诊宫腔镜检查正常的29例不孕妇女作为对照组。采用免疫组化方法测定ER和PR在子宫内膜息肉和正常增殖期子宫内膜中的表达,同时采用化学发光法测定所有患者血清的基础性激素(血清卵泡刺激素、黄体生成素、催乳素、雌二醇和睾酮)水平,并对两组的基本情况(年龄、不孕类型、不孕原因、不孕年限及取材时间)进行比较。结果:两组基础性激素水平和基本情况的比较中,仅EP组血清雌二醇水平显著高于对照组(223.39±125.47pmol/Lvs169.96±87.46pmol/L,P=0.046),其他各项指标的比较,差异均无统计学意义(P>0.05)。ER和PR在子宫内膜息肉和增殖期子宫内膜中的表达比较,差异均无统计学意义(P=0.085,P=0.527)。结论:对于无月经改变的不孕症子宫内膜息肉,长期较高水平的雌二醇刺激可能与息肉形成有关,但子宫内膜息肉上ER、PR表达未见异常。     

雌、孕激素对人宫颈癌HeLa细胞体外生长影响的研究

目的 :探讨雌二醇 (E2 )、孕酮 (P)对人宫颈癌HeLa细胞体外增殖及凋亡的影响。方法 :体外培养人宫颈癌HeLa细胞 ,免疫组化方法 ,测定其雌激素受体 (ER)、孕激素受体 (PR)的表达 ;不同浓度的E2 、P和E2 +P作用于HeLa细胞 ,采用四甲基偶氮唑蓝(MTT)比色法观测HeLa细胞的增殖 ;流式细胞仪 (FCM)检测细胞周期、细胞凋亡率及细胞内bcl 2蛋白的表达 ;光学、电子显微镜检测其形态学和超微结构变化。结果 :HeLa细胞PR表达明显高于ER(P <0 .0 1)。E2 对HeLa细胞有明显促生长作用 (P <0 .0 1) ,P和E2 +P对细胞生长有明显的抑制作用 (P <0 .0 1) ,增殖抑制率与浓度呈正相关 (P <0 .0 5 )。FCM显示E2 组细胞周期S期比例上升 ,凋亡率下降 ,细胞内bcl 2蛋白表达上升 ;P组和E2 +P组G0 /G1期细胞比例上升 ,S期细胞比例下降 ,凋亡率上升 ,细胞内bcl 2蛋白表达下降 (P <0 .0 1)。光镜和电镜可见E2 组细胞生长良好 ,P组和E2 +P组可见细胞凋亡的形态学改变。结论 :E2 对宫颈癌HeLa细胞具有促进增殖、抗凋亡作用 ;P则抑制HeLa细胞增殖 ,并诱导其凋亡 ;E2 +P显示了抑制增殖、诱导凋亡的增强作用。足量的P可拮抗E2 对宫颈癌细胞的促增殖作用。     

A comparative study of the estrogen receptor ratio in myometrium and uterine leiomyomas

Estrogen receptor (ER) content in myoma and myometrium was determined by radio-receptor assay (RRA), and ER staining was performed by immunocytochemical staining, i.e. the peroxidase-antiperoxidase (PAP) method, in uterine samples from eight patients with uterine leiomyoma. ER content in myoma tended to be hither than that in myometrium, but the difference was not significant. The distribution pattern of ER staining was thought to be an important criterion. When the data were compared on the basis of the number of cells in the site where the largest number of positive cells aggregated, the number for myoma was significantly higher than that for myometrium (P less than 0.05). These results suggest that myoma contains more ER positive cells to obtain estrogen effects than myometrium.     

A comparison of radioreceptor assay and immunocytochemical staining for estrogen receptor in leiomyoma and myometrium

Estrogen receptor (ER) content in myoma and myometrium was determined by radioreceptor assay (RRA), and ER staining was performed by immunocytochemical staining, i.e., the peroxidase-antiperoxidase (PAP) method, in uterine samples from eight patients with uterine leiomyoma. ER content in myoma tended to be higher than that in myometrium, but the difference was not significant. The distribution pattern of ER staining was thought to be an important criterion. When the data were compared on the basis of the number of cells in the site where the largest number of positive cells aggregated, the number for myoma was significantly higher than that for myometrium (p less than 0.05). These results suggest that myoma contains more ER positive cells and more efficiently absorbs estrogen than myometrium.     

Endometrial steroid receptor during normal menstrual cycle and physiopathology of nidation

Human uterine endometrial steroid receptor [estrogen (ER), progestin (PR) and androgen (AR) receptors] in the normal menstrual cycle were determined at the cellular level. Endometria with pathological out-of-phase findings or with hypoplastic uterus were evaluated for the concentration of steroid receptors, for a better understanding of their pathophysiology. ER and PR levels gradually rose toward the early secretory phase, remained at the maximum level during the mid-secretory phase and dropped to the lowest level during the late secretory phase. Especially nuclear PR reached the maximum level during the mid-secretory phase. These results indicate that the endometrial ER and PR, especially the endometrial nuclear PR, is kept in the maximum level at implantation. AR showed only a slight change in a very low level throughout the menstrual cycle. This indicates that androgen may not play so important a role in endometrial physiology. Endometria with out-of-phase or with hypoplastic uterus contained significantly low levels of endometrial ER and PR, while serum hormones levels were normal. This indicates indigenous reduction of ER and PR synthesis in such endometria.     

Correlation between concentration of cytosol estradiol receptors and activities of RNA and protein synthesis in uterine myoma

In an attempt to clarify the relationship between estradiol and uterine myoma, the concentration of the cytosol estradiol receptors (E2R) and the activities of RNA and protein syntheses (RS and PS) in uterine myoma and corresponding myometrium were measured. A 105,000 X g supernatant of tissue homogenate from which endogenous unbound steroid was removed by dextran-coated charcoal was used for the cytosol. Binding was measured by using the charcoal adsorption technique. RS and PS had been determined by the incorporation of 3H-Uridine and 14C-Leucine to the fresh tissue at 37 degrees C for 3 hours. The differences between paired samples of myoma and myometrium from the same uterus were statistically analyzed and the following results were obtained: The concentration of E2R in myoma was significantly higher than that in myometrium. But there was no significant difference in RS and PS between myoma and myometrium. There was a close correlation of the concentration of E2R, RS and PS between myoma and myometrium from the same uterus. The concentration of E2R did not correlate to RS and PS in myoma, whereas RS correlated with PS in myoma.     

The role of progesterone in endometrial estradiol- and progesterone-receptor synthesis in women with menstrual disorders and habitual abortion

The objective of this comparative study was to determine the influence of changes in estradiol and progesterone during ovulatory vs. anovulatory cycles on levels of estradiol receptor (ER) and progesterone receptor (PgR) in endometrium. Thirty women (range age 20–35 years) were divided into three groups: women with a history of habitual abortion, obese women with menstrual disorders, and women with regular ovulatory cycles as well as proven fertility. A single venous blood sample and an endometrial sample were simultaneously obtained during the secretory phase of the menstrual cycle, in order to measure estradiol and progesterone levels and ER and PgR concentrations in cytosol and salt-extracted nucleosol. Plasma estradiol levels were not different between groups. Plasma progesterone was two times higher in fertile women than in habitual aborters. In endometrial tissue, progesterone content was 200 times higher in fertile women than in habitual aborters. ER and PgR were lower in the cytosol than in the nuclear fraction in fertile and obese women. Both receptors were at their lowest level in the cytosol and nuclear compartment of women with recurrent miscarriage. Fluctuations mainly in the sex hormone progesterone, in plasma and endometrium tissue, could interfere with ER and PgR levels.     

The role of progesterone in endometrial estradiol- and progesterone-receptor synthesis in women with menstrual disorders and habitual abortion.

The objective of this comparative study was to determine the influence of changes in estradiol and progesterone during ovulatory vs. anovulatory cycles on levels of estradiol receptor (ER) and progesterone receptor (PgR) in endometrium. Thirty women (range age 20-35 years) were divided into three groups: women with a history of habitual abortion, obese women with menstrual disorders, and women with regular ovulatory cycles as well as proven fertility. A single venous blood sample and an endometrial sample were simultaneously obtained during the secretory phase of the menstrual cycle, in order to measure estradiol and progesterone levels and ER and PgR concentrations in cytosol and salt-extracted nucleosol. Plasma estradiol levels were not different between groups. Plasma progesterone was two times higher in fertile women than in habitual aborters. In endometrial tissue, progesterone content was 200 times higher in fertile women than in habitual aborters. ER and PgR were lower in the cytosol than in the nuclear fraction in fertile and obese women. Both receptors were at their lowest level in the cytosol and nuclear compartment of women with recurrent miscarriage. Fluctuations mainly in the sex hormone progesterone, in plasma and endometrium tissue, could interfere with ER and PgR levels.