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目的探讨雌激素受体β(ERβ)与子宫内膜息肉(EP)发病的关系。方法采用免疫组化链霉菌抗生物素蛋白-过氧化物酶链接(SP)法,检测72例EP患者[其中36例合并不孕(不孕组),36例为带宫内节育器后发生EP(置器组)]的EP和正常子宫内膜组织ERβ、ERα含量[用吸光度(A)值表示],同时采用放射免疫法检测EP患者外周血中雌二醇浓度。结果(1)不孕组和置器组患者EP间质细胞中ERβ含量分别为2·1±0·9和1·9±0·5,明显高于两组同时期子宫内膜间质细胞中的含量(1·7±0·3,1·3±1·1),分别比较,差异均有统计学意义(P<0·05);(2)不孕组患者外周血和EP组织中雌二醇浓度分别为(66·4±12·8)pmol/L和(3·0±0·7)pmol/L,二者呈正相关关系(r=0·789,P<0·01);置器组患者外周血和EP组织中雌二醇浓度分别为(67·4±13·4)pmol/L和(2·8±0·7)pmol/L,二者也呈正相关关系(r=0·792,P<0·01)(3)EP中ERβ的含量与EP中雌二醇浓度呈正相关,且与外周血雌二醇浓度呈正相关;(4)两组ERα在EP间质细胞中的表达较其在相同时期的子宫内膜间质中的表达明显下降(P<0·05);且ERα含量与EP中雌二醇浓度无明显相关性,与外周血雌二醇浓度也无明显相关性。结论ERβ在子宫内膜间质细胞中的过度表达,可能是导致EP发病的原因之一。
Objective To investigate the relationship between estrogen receptor β (ERβ) and the pathogenesis of endometrial polyps (EP). Methods Immunohistochemical streptavidin - peroxidase linked (SP) method was used to detect 72 cases of EP patients [including 36 cases of infertility (infertility group), 36 cases occurred after intrauterine device EP group and EP group, and ERα level in normal endometrial tissue [expressed as absorbance (A)]. The estradiol concentrations in peripheral blood of patients with EP were measured by radioimmunoassay. Results (1) The content of ERβ in EP group was 2.1 ± 0.9 and 1.9 ± 0.5 respectively in infertility group and control group, which was significantly higher than that in the same group of endometrial stromal cells (1.7 ± 0.3, 1.3 ± 1.1), respectively, the differences were statistically significant (P <0 · 05); (2) The levels of peripheral blood and EP in the infertility patients (66.4 ± 12.8) pmol / L and (3.0 ± 0.7) pmol / L, respectively (r = 0.789, P <0.01) ). The concentrations of estradiol in the peripheral blood and EP tissue of the catheterization group were (67.4 ± 13.4) pmol / L and (2.80 ± 0.7) pmol / L, respectively, which were also positively correlated (r = 0.772, P <0.01). (3) The content of ERβ in EP was positively correlated with the concentration of estradiol in EP and positively correlated with the concentration of estradiol in peripheral blood. (4) The expression of stromal cells was significantly lower than that in the endometrial stroma at the same time (P <0.05). There was no significant correlation between the level of ERα and the concentration of estradiol in EP, There was no significant correlation between alcohol concentrations. Conclusion ERβ overexpression in endometrial stromal cells may be one of the reasons leading to the pathogenesis of EP.