ER、PR和GHR在宫腔粘连患者子宫内膜组织中的表达及意义

发布时间：2018-09-11 07:45

【摘要】：目的研究生长激素受体(GHR)、雌激素受体(ER)、孕激素受体(PR)在宫腔粘连(研究组)和非宫腔粘连(对照组)患者子宫内膜组织中的表达情况,为宫腔粘连患者在经阴道宫腔镜下宫腔粘连分离术(TCRA)术后使用生长激素、雌激素、孕激素预防再粘连提供一定的理论参考。方法1、资料来源研究组:2013年11月至2014年05月在我院妇科行宫腔镜检查并确诊为宫腔粘连患者28例为研究组,年龄20~35岁,平均年龄29.62±2.52岁。对照组:同期因其他原因(不孕、子宫纵膈或节育器嵌顿)在宫腔镜检查下确诊为非宫腔粘连患者22例为对照组,年龄21~40岁,平均年龄26.80±3.34岁。并且这些非宫腔粘连患者既往都有宫腔操作史。2、实验方法2.1标本采集。研究组:患者均行宫腔镜检查确诊为宫腔粘连,在宫腔镜检查中或经阴道宫腔镜下宫腔粘连分离术操作过程中,视需要在尚残存的正常子宫内膜组织中,用异物钳钳取适量(质量约20 mg)的内膜组织作为标本。对照组:患者因其他原因行宫腔镜检查确认为非宫腔粘连且既往都有过宫腔操作史,如子宫纵膈、不孕或节育器嵌顿,按需要钳取适量正常子宫内膜组织。2.2实验方法。采用免疫组化Max Vision两步法和实时荧光定量PCR(q RTPCR)方法分别检测两组患者子宫内膜组织中GHR蛋白、ER蛋白、PR蛋白和GHRm RNA、ERm RNA、PR m RNA的表达情况。结果1、免疫组化Max Vision两步法检测研究组和对照组ER蛋白、PR蛋白、GHR蛋白表达;实时荧光定量PCR实验方法检测研究组和对照组ERm RNA、PRm RNA、GHRm RNA表达;两种实验方法检测GHR、ER在两组中表达有显著统计学意义(P0.05),PR在两组中表达无统计学意义(P0.05)。2.采用免疫组化Max Vision两步法检测子宫内膜腺体与子宫内膜间质中ER、PR和GHR蛋白表达,两部位比较差异有统计学意义(P0.05)。结论1.研究组患者子宫内膜组织中的GHR表达低于对照组,而且这种表达在两组子宫内膜腺体中较多,而在两组子宫内膜间质中表达较少,为宫腔粘连患者在TCRA术后使用生长激素预防再粘连提供一定的理论参考。2.研究组患者子宫内膜组织中ER表达高于对照组,PR表达在两组之间无差异;ER、PR在两组子宫内膜腺体中表达较多,而在两组子宫内膜间质中表达较少甚至不表达;为宫腔粘连患者在TCRA术后使用雌激素和孕激素预防再粘连提供一定的理论参考。
[Abstract]:Objective to study the expression of growth hormone receptor (GHR), estrogen receptor (ER), progesterone receptor (PR) in endometrium of patients with intrauterine adhesions (study group) and non-uterine adhesions (control group). To provide a theoretical reference for the prevention of adhesions by growth hormone, estrogen and progesterone in patients with intrauterine adhesions after (TCRA) under transvaginal hysteroscopy. Methods 1. Data source study group: from November 2013 to May 2014, 28 patients with intrauterine adhesion were diagnosed by hysteroscopy in our hospital. The age was 2035 years old with an average age of 29.62 卤2.52 years. Control group: 22 cases of non-uterine adhesions diagnosed by hysteroscopy for other reasons (infertility, uterine mediastinal or IUD incarceration) were the control group. The average age was 26.80 卤3.34 years. And these patients with non-uterine adhesions had a history of intrauterine operations of. 2. 2 and 2. 1 specimens were collected. Study group: all the patients underwent hysteroscopy to diagnose intrauterine adhesions, and during hysteroscopy or vaginal hysteroscopy, in the normal endometrial tissues which remained as needed during the operation of hysteroscopy or vaginal hysteroscopy, The appropriate amount of intimal tissue (about 20 mg mass) was obtained by using foreign body forceps. Control group: the patients were confirmed by hysteroscopy as non-intrauterine adhesions for other reasons and had previous history of uterine cavity operation, such as mediastinal uterus, infertility or incarceration of sterility or device, and appropriate amount of normal endometrial tissue .2.2 was obtained according to the need of forceps. The expression of GHR protein ER protein, PR protein and GHRm RNA,ERm RNA,PR m RNA in endometrium of two groups were detected by immunohistochemical Max Vision two-step method and real-time fluorescence quantitative PCR (q RTPCR) method. Results 1. The expression of ER protein and PR protein in study group and control group were detected by immunohistochemical Max Vision two-step method, and the expression of ERm RNA,PRm RNA,GHRm RNA in study group and control group was detected by real-time fluorescence quantitative PCR assay. Two experimental methods to detect the expression of GHR,ER in the two groups had significant statistical significance (P0.05) the expression of PR in the two groups had no statistical significance (P0.05). 2. The expression of ER,PR and GHR in endometrium and endometrial stroma was detected by immunohistochemical Max Vision two-step method. The difference between the two sites was statistically significant (P0.05). Conclusion 1. The expression of GHR in endometrial tissue of study group was lower than that in control group, and the expression was more in endometrial gland and less in stroma of endometrium in both groups. To provide a theoretical reference for the patients with intrauterine adhesion after TCRA to use growth hormone to prevent re-adhesion. 2. The expression of ER in endometrial tissue of study group was higher than that of control group. There was no difference between the two groups in the expression of ERP in the endometrial gland of the two groups, but there was little or no expression in the stroma of endometrium in the two groups. To provide a theoretical reference for the use of estrogen and progesterone in patients with intrauterine adhesion after TCRA.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R711.74

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