ARID1A及雄激素受体在子宫内膜增生病变组织中的表达及意义

发布时间：2018-04-08 11:56

本文选题：子宫内膜增生症　切入点：ARID1A基因　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:研究AT丰富结构结构域1A(AT rich interaction domain 1A,ARID1A)ARID1A基因、雄激素受体(AR)在子宫内膜增生症不同病变中的表达情况,同时分析其与雌激素受体(ER)、孕激素受体(PR)的相关性,探讨ARID1A、AR在子宫内膜增生症发生发展中的作用,旨在了解子宫内膜增生症的病因和发病机制,探索子宫内膜增生症防治的新的思路,为预防和降低子宫内膜癌的发生奠定理论依据。方法:选取2013年1月至2016年6月山西省妇幼保健院病理科132例子宫内膜增生症组织标本(包括单纯型增生40例,复杂型增生40例,不典型增生52例),选取同期增殖期子宫内膜组织28例作为对照组,所有标本均经过病理学证实,3个月内未接受激素治疗。懫用免疫组织化学方法(streptavidin peroxidase-biotin,SP)检测ARID1A、ER、PR、AR在增殖期内膜、子宫内膜增生各级别病变组织中的表达。应用SPSS21.0进行统计分析,ARID1A、ER、PR、AR蛋白表达率运用x2检验;ARID1A、AR与ER、PR表达相关性用Spearman相关分析。结果:1、子宫内膜组织中广泛存在ER、PR、AR的表达,ER、PR在增殖期子宫内膜、单纯型增生、复杂型增生、不典型增生各组间差异无统计学意义(P=0.143,P=0.496);AR在不典型增生组阳性表达率最低,与其余各组间比较,差异具有统计学意义(P=0.018),增殖期内膜组,单纯型增生组、复杂型增生组,各组间比较,差异无统计学意义(P0.05)2、ARID1A基因在子宫内膜腺上皮和间质细胞核中广泛表达,随着病变的发展,ARID1A基因表达的缺失率逐渐增加,在不典型子宫内膜组中,ARID1A表达缺失率为19.2%,与其余组间比较,差异有统计学意义(x2=11.58,P=0.004),(P0.05)3、子宫内膜增生组织中ARID1A与ER、PR、AR之间无明显的相关性(rs=-0.066,P=0.455;rs=0.001,P=0.987;rs=0.114,P=0.191);AR与ER、PR的表达呈正相关性(rs=0.176,P=0.043;rs=0.195,P=0.025)。结论:1、ARID1A基因突变和表达缺失是子宫内膜增生恶变过程中的一个早期事件。2、雄激素及其受体可能参与了子宫内膜增生症的发生发展。3、对于AR阳性的部分子宫内膜增生患者,联合降低雄激素治疗,有可能成为子宫内膜增生症治疗的一个新的策略。
[Abstract]:Objective: to study the expression of 1A(AT rich interaction domain 1AnARID1A gene and androgen receptor ARID1A in different lesions of endometrial hyperplasia, and to analyze the relationship between AT rich domain and estrogen receptor ERA and progesterone receptor.To explore the role of ARID1 Agnar in the occurrence and development of endometrial hyperplasia, to understand the etiology and pathogenesis of endometriosis, and to explore a new idea for the prevention and treatment of endometriosis.In order to prevent and reduce the occurrence of endometrial carcinoma lay a theoretical basis.Methods: from January 2013 to June 2016, 132 specimens of endometrial hyperplasia (including 40 cases of simple hyperplasia and 40 cases of complex hyperplasia) were collected from Department of Pathology of Shanxi Maternal and Child Health Hospital.52 cases of atypical hyperplasia and 28 cases of proliferative endometrium were selected as control group. All the specimens were confirmed by pathology and did not receive hormone therapy within 3 months.The expression of AR in proliferative endometrium and endometrial hyperplasia was detected by immunohistochemical method (streptavidin peroxidase-biotin SPN).SPSS21.0 was used to analyze the expression rate of AR protein in ARID1 Agna. The correlation between AR and PR was analyzed by Spearman correlation analysis with x2 test.Results there was no significant difference in the expression of ERP PRAR in endometrial tissues in proliferative endometrium, simple hyperplasia, complex hyperplasia and atypical hyperplasia. The positive rate of ERP was the lowest in atypical hyperplasia group.Compared with the other groups, the difference was statistically significant (P 0.018), the proliferative endometrium group, simple hyperplasia group, complex hyperplasia group, and there was no significant difference in the expression of ARID1A gene in endometrial glandular epithelium and interstitial nucleus, and there was no significant difference in the expression of ARID1A gene in endometrial glandular epithelium and interstitial nucleus.With the development of pathological changes, the deletion rate of ARID1A gene increased gradually, and the deletion rate of ARID1A gene in atypical endometrium was 19.2%, compared with other groups.Conclusion the mutation and deletion of ARID1A gene is an early event in the process of endometrial hyperplasia and malignant transformation. Androgen and its receptor may be involved in the occurrence and development of endometrial hyperplasia .3. for some patients with AR positive endometrial hyperplasia, androgen and its receptor may be involved in the occurrence and development of endometrial hyperplasia.Combined androgen reduction therapy may be a new strategy for the treatment of endometrial hyperplasia.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.74

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