【摘要】 目的了解阴道前壁膨出(AVP)患者阴道组织中雌激素受体(ER)α、β亚型的表达情况,探讨其与盆腔器官脱垂(POP)发病的关系。方法选取1999年7月—2004年7月在北京大学人民医院手术治疗的 AVP 患者40例(AVP 组),其中绝经前7例,绝经后33例。对照组为同时期手术的Ⅰb1～Ⅱb期宫颈鳞癌患者17例(无盆腔器官膨出症状),其中绝经前9例,绝经后8例。应用免疫组化方法检测阴道前壁组织中鳞状上皮、黏膜固有层、肌层3个部位的 ERα和 ERβ表达水平(以阳性细胞率及阳性染色强度的评分判断 ER 的表达水平),进行半定量分析及统计学检验。结果(1)ERα、ERβ在 AVP 组患者阴道组织中鳞状上皮、黏膜固有层、肌层均有表达。(2)AVP 组绝经前患者阴道组织中 ERα表达水平分别为:鳞状上皮(5.3±0.8)分、黏膜固有层(3.2±2.1)分、肌层(3.0±1.5)分,绝经后患者分别为(4.6±1.2)、(4.1±1.2)、(3.7±1.4)分,绝经前、后患者不同部位分别比较,差异均无统计学意义(P>0.05);对照组患者的阴道组织中 ERα表达水平在绝经前、后比较,差异也无统计学意义(P>0.05)。(3)ERβ表达水平在绝经前、后 AVP 组患者阴道组织中比较,差异无统计学意义(P>0.05);而对照组绝经前患者阴道组织中 ERβ表达水平分别为:鳞状上皮(4.2±0.5)分、黏膜固有层(2.6±1.4)分、肌层(2.4±0.8)分,绝经后患者分别为(2.6±1.3)、(1.1±0.7)、(1.4±0.9)分,对照组绝经后患者阴道组织中 ERβ的表达水平下降(P<0.05)。(4)AVP 组绝经后患者阴道组织中 ERβ表达水平分别为:鳞状上皮(4.1±1.6)分、黏膜固有层(3.4±1.7)分、肌层(3.3±1.2)分,绝经后 AVP 组患者阴道组织各部位 ERβ的表达水平高于绝经后对照组患者相应部位(P<0.05);而绝经后患者 ERα在阴道组织中的表达水平,AVP 组与对照组比较,差异无统计学意义(P>0.05)。结论无论绝经前、绝经后 AVP 患者,阴道组织都存在 ERα、ERβ的表达。AVP 患者阴道组织中 ERB 表达在绝经后未下降,且较对照组绝经后患者表达增加,而 ERα无明显变化。更多还原

【Abstract】 Objective To observe the expression of estrogen receptor(ER)α and ERβ in the vaginal wall of women with anterior vaginal prolapse,and to investigate the relationships of ER subtypes with the development of pelvic organ prolapse(POP).Methods Seven premenopausal women and 33 postmenopausal women with anterior vaginal prolapse who underwent surgery in our hospital from July 1999 to July 2004 were analyzed.Nine premenopausal and 8 postmenopausal women with squamous carcinoma of cervix who underwent surgery served as controls.The expression of ERα and ERβ in squamous epithelium (SE),lamina propria(LP)and muscular layer(ML)of anterior vaginal wall were studied by immunohistochemical staining.Results(1)Both ERα and ERβ were expressed in SE,LP,ML of vaginal wall of premenopausal and postmenopausal women.(2)The expression of ERα was not significantly different in premenopausal and postmenopausal women;the expression of ERβ was not significantly different in premenopausal and postmenopausal women with POP;however,it was decreased in postmenopausal women without POP(P<0.05).(3)The expression of ERβ was significantly higher in postmenopausal POP group than in postmenopausal control group(P<0.05).The expression of ERα was not significantly different in postmenopausal control and postmenopausal POP group.Conclusions ERα and ERβ are expressed in vaginal wall of premenopausal and postmenopausal women.In vaginal wall of postmenopausal women with POP,the expression of ERβ is not decreased;on the contrary,it is increased compared with that of postmenopausal control.ERα is not changed significantly.更多还原