【作者】 高磊；

【导师】 郭新华；

【作者基本信息】 青岛大学 ， 妇科内分泌， 2003， 硕士

【摘要】 目的 通过检测子宫肌瘤中胰岛素样生长因子-Ⅰ(IGF-Ⅰ)及其受体(IGF-ⅠR)、雌、孕激素受体(ER、PR)的表达，推断IGF-Ⅰ在子宫肌瘤发生发展中的作用。 方法 采用免疫组化链霉素抗生物素-过氧化酶染色法(S-P)和流式细胞术检测30例子宫肌瘤患者肌瘤组织中IGF-Ⅰ、IGF-ⅠR、ER、PR的表达，取子宫肌瘤周围正常平滑肌肌组织为对照。 结果 1．IGF-Ⅰ在子宫肌瘤组织中高表达，子宫肌瘤组织IGF-Ⅰ的SP染色强度与正常肌细胞相比明显增强，强阳性和中强阳性染色的比例达80％，而对照组仅有40％，差异有统计学意义(P＜0.05)，流式细胞术结果显示肌瘤组织中IGF-Ⅰ表达量(6.24±1.46)高于其周围正常子宫肌层(5.58±1.07)，差异有统计学意义(P＜0.01)。2．子宫肌瘤中IGF-ⅠRα、IGF-ⅠRβ的SP染色均较正常肌组织增强，差异有极显著统计学意义(P＜0.01，P＜0.01)，IGF-ⅠR的流式细胞术结果显示，子宫肌瘤中IGF-ⅠR的表达量(7.39±0.54)较肌组织(5.14±0.51)显著增强，差异有显著性(P＜0.01)。3．ER、PR在子宫肌瘤组织高表达，子宫肌瘤中ER、PR阳性细胞数明显多于子宫平滑肌组织，SP染色强度增高，与对照组比较差异有统计学意义(P＜0.05，P＜0.05)，流式细胞术检测子宫肌瘤中ER表达量高于对照组，且子宫肌瘤增值期中IGF-Ⅰ与ER的表达呈正相关，结果有统计学意义(r=0.832，P＜0.01)。 结论 1．子宫肌瘤细胞不仅具有分泌IGF-Ⅰ的能力，而且表达强度明显高于正常子宫平滑肌组织，IGF-Ⅰ与受体结合后将信号传导进入细胞核，发挥致细胞有丝分裂作用，使肌瘤细胞不断增殖、生长，在子宫肌瘤的中文摘要生长过程中起重要作用。2.工GF一IR在子宫肌瘤细胞中高表达，不仅增加子宫肌瘤细胞摄取工GF一I、传递信息的能力，而且在子宫肌细胞转化形成肌瘤细胞的过程中起十分重要的作用。3.工GF一工可能作为性激素的调节因子，通过介导性激素的作用，进一步促进子宫肌瘤的生长。工GF一I作为雌激素的介质，以自/旁分泌的形式发挥作用，放大雌激素引起的增殖信号，进一步促进子宫肌瘤生长，此外工GF一I调节孕激素的合成也是子宫肌瘤病情不断发展的原因之一。更多还原

【Abstract】 Objective to study the expression of insulin-like growth factor-I (IGF- I ) and insulin-like growth factor- I receptor (IGF- I R), estrogen receptor(ER) and progesterone receptor (PR) in the uterine leiomyoma and to investigate the pathogenesis of uterine leiomyoma. Methods Immunohistohemical method (Strepavidin-Peroxide) was employed to detect the expression of IGF- I , IGF- I R,ER and PR in both uterine leiomyoma and myometrium(as normal control) of patients,and flow cytometry (FCM) was performed to ensure the exactly expression value of what was to study.Result 1.IGF- I were overexpressed in the uterine leiomyoma and there was a significant higher SP positive stained in uterine leiomyoma than that in normal myometrium. positive cell rate was 80% to 40%(P<0.05). statistical difference was significant. flow cytometry result of IGF-I in the uterine leiomyoma (6.24 ± 1.46) was higher than control class (5. 58±1. 07, P<0. 01). 2. The staining of IGF- I Ra and IGF-I 3 were stronger in uterine leiomyoma than that in myometrium(P<0. 01), and IGF- I R expression was in high level in FCM (7. 39 ± 0. 54, P<0. 01), the FCM value of myometrium was (5. 14 ± 0. 51) 3. the result of ER and PR in the uterine leiomyoma were higher than that in normal myometrium (P<0.05,OP<0. 05) , and the expression of IGF- I in uterine proliferation phrase was positive corelated with expression of ER(r=0.832,p<0. 01)Conclusions 1. uterine leiomyoma have the capacity of secretion IGF-I and have higher expression than the expression of IGF- I in theuterine smooth muscle cells. IGF- 1 improve the growth of uterineleiomyoma in short time by enhance the mitosis of the cells, which playan important role in the pathogenesis of this tumor.2. IGF-I receptor are overexpresssd in the uterine leiomyoma than in the myometrium, which not only promote hormone uptaking, information convection, but also have effect on uterine smooth muscle conversion and uterine leiomyome formation.3. IGF- I further improve uterine leiomyoma growth through introducing the action of sex hormone. IGF-I act as a mediator of estrogen, enlargement the proliferation signal of estrogen by auto/paracrine pattern. IGF- I also enhance cells mitosis and growth of uterine leiomyoma indirectly by regulating progestin synthesis.更多还原