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目的探讨绝经后妇女子宫内膜息肉的治疗方法。方法绝经期子宫内膜息肉患者71例,均接受宫腔镜下经宫颈息肉切除术(TCRP)治疗,术后未应用其他治疗。术后病理均诊断为子宫内膜息肉。采用免疫组化法检测蜡块组织中的雌激素受体(ER)和孕激素受体(PR)的表达。判定标准:计数10个高倍镜(×400)视野下的有黄染颗粒细胞个数,0个为阴性,1%￣10%为(+),11%￣50%为(++),>50%为(+++)。结果ER和PR在患者子宫内膜中的表达水平均较低,有74.6%和70.4%的患者无ER和PR的表达。而在绝经期子宫内膜息肉中ER和PR的表达水平较高,表达率分别为77.5%和69.0%,与子宫内膜比较有显著性差异(P值分别为0.019和0.001)。在4例曾经应用激素替代治疗的患者中,3例绝经时间>5年,内膜中ER、PR均为阴性;另1例绝经2年,内膜中受体表达ER(++),PR(++),但无临床症状。结论绝经后,ER和PR的表达水平在正常子宫内膜与子宫内膜息肉中不同,提示绝经期子宫内膜息肉的发生可能同时与雌、孕激素受体水平有关,治疗时可以考虑单纯手术去除病灶。
Objective To investigate the treatment of endometrial polyps in postmenopausal women. Methods Seventy-one patients with endometrial polyps were treated by hysteroscopic cervical polypectomy (TCRP) without any other treatment. Postoperative pathology were diagnosed as endometrial polyps. The expression of estrogen receptor (ER) and progesterone receptor (PR) in wax tissue was detected by immunohistochemistry. Criteria: counting the number of yellow-stained granulosa cells in the field of 10 high magnification lenses (× 400), 0 were negative, 1% ~ 10% (+), 11% ~ 50% 50% is (+++). Results The expression levels of ER and PR in patients with endometrium were low, and there was no expression of ER and PR in 74.6% and 70.4% of the patients. However, the expression of ER and PR in postmenopausal women with endometrial polyps was significantly higher than that in the endometrium (P = 0.019 and 0.001). The expression rates of ER and PR were 77.5% and 69.0% respectively. Of the 4 patients who had been treated with hormone replacement therapy, 3 had postmenopausal time> 5 years, negative endometrial ER and PR, and 1 had menopausal 2 years with endometrial ER (++), PR (++), but no clinical symptoms. Conclusions After menopause, the expressions of ER and PR are different between normal endometrium and endometrial polyps, suggesting that the occurrence of endometrial polyps in menopause may be related to the levels of estrogen and progesterone receptor. Simple surgical treatment Remove the lesion.