【摘要】 目的　观察孕激素醋酸甲羟孕酮、抗孕激素米非司酮单用以及二者联用对子宫内膜癌形态学的影响 ,并探讨其作用机制。方法　 2 7例经诊断性刮宫确诊的子宫内膜腺癌患者随机分三组 ,分别于术前用米非司酮、醋酸甲羟孕酮或二者联合治疗 5天。用药前后对照观察癌组织形态学改变 ,并用半定量方法比较其腺体结构、腺体分泌反应、间质蜕膜样反应及核分裂相的变化。结果　用药前各组间各指标比较无明显差异 (P >0 .0 5 )。用药后各组均呈现癌细胞分化趋向成熟改变 ,腺体结构明显 (P<0 .0 1) ,分泌活跃 (P<0 .0 1) ,核分裂相减少 (P<0 .0 1) ,并出现蜕膜样反应 (P <0 .0 1) ,可见细胞凋亡现象。三组间比较以联合用药组变化最明显 ,其各指标的改变均明显优于单独用药组 (P <0 .0 1)。米非司酮组和醋酸甲羟孕酮组间比较无明显差异 (P >0 .0 5 )。结论　米非司酮和醋酸甲羟孕酮均可使子宫内膜腺癌细胞生长受抑制 ,分化趋向成熟 ,二者联用优于单独应用。更多还原

【Abstract】 Objective To observe the morphologic changes of endometrial adenocarcinoma treated with mifepristone and progesterone and to explore the possible mechanisms associating with them.Methods 27 untreated patients with endometrial adenocarcinoma were divided into 3 groups at random.Each group was given medroxyprogesterone acetate (MPA) or mifepristone (MIF) or MPA+MIF for 5 days respectively.On the sixth day, hysterectomy was performed on these patients.The endometrial cancer specimen of post-hysterectomy was contrasted with the one of pre-administrating.The morphologic changes of the endometrial cancer cells were observed through light microscope and were compared in the gland structure, the gland excretion reaction,the interstitial decidual alteration and the karyokinesis.Results There was no difference among the three groups before treatment (P>0.05).All of the post-hysterectomy endometrial specimen showed well differentiation,better gland structure (P<0.01), increased in secretory activity (P<0.01),more interstitial decidual alteration (P<0.01),decreased in the karyokinesis (P<0.01) and apoptosis of tumor cells.The change showed significant difference among the three groups(P<0.01) , no difference between the MIF group and the MPA group(P>0.05).Conclusions MPA and MIF could inhibit the growth of endometrial adenocarcinoma cells and lead to well differentiation and the united use of mifepristone and progesterone is better than the respective ones.更多还原