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目的研究雌激素(ER)和雄激素(AR)受体与泌乳素腺瘤临床表现之间的相关关系,探讨泌乳素腺瘤发病机理中ER和AR表达可能存在的性别差异。方法搜集同济医院2000年12月～2001年12月期间经蝶窦手术的30例泌乳素腺瘤病例,实验分为两部分。第一部分：回顾性分析了病人性别、年龄、血浆泌乳素水平、肿瘤的大小、侵袭性、CT和MRI以及手术发现、术前使用溴隐亭情况和肿瘤复发等临床资料,第二部分：选取30例中的20例泌乳素腺瘤标本,用免疫组化技术检测了ER和AR的表达。运用卡方检测行统计学分析泌乳素腺瘤的各种临床特点和ER、AR表达间的关系。结果统计分析结果显示ER和AR的表达与泌乳素腺瘤的特征如：性别、年龄、肿瘤体积、肿瘤的侵袭性无关(P＞0.05)。结论泌乳素腺瘤的性别、年龄、肿瘤体积、肿瘤的侵袭性程度不会影响ER和AR的表达。男性泌乳素腺瘤较女性患者更具侵袭性。单纯手术治疗巨大腺瘤或血浆泌乳素＞200ng／mL的肿瘤疗效并不理想。手术后溴隐亭治疗的应用与患者的性别无关,但与手术前肿瘤的体积和泌乳素水平相关。
Objective To study the correlation between estrogen (ER) and androgen receptor (AR) and the clinical manifestations of prolactinomas and to explore the possible gender differences in the expression of ER and AR in the pathogenesis of prolactinomas. Methods Thirty cases of prolactinoma of the sphenoid sinus in Tongji Hospital from December 2000 to December 2001 were collected. The experiment was divided into two parts. Part I: A retrospective analysis of the patient’s sex, age, plasma prolactin levels, tumor size, invasiveness, CT and MRI and surgical findings, preoperative use of bromocriptine and tumor recurrence and other clinical data, the second part: 20 cases of prolactinoma specimens in 30 cases, the expression of ER and AR were detected by immunohistochemistry. The use of chi-square test line statistical analysis of various clinical features of prolactinomas and ER, AR expression of the relationship. Results The results of statistical analysis showed that the expression of ER and AR was not associated with the characteristics of prolactinomas such as gender, age, tumor volume, tumor invasion (P> 0.05). Conclusions The sex, age, tumor volume and tumor invasiveness of prolactinomas do not affect the expression of ER and AR. Male prolactinomas are more aggressive than female patients. Surgical treatment of giant adenoma or plasma prolactin> 200ng / mL tumor efficacy is not satisfactory. The use of bromocriptine after surgery has nothing to do with the sex of the patient but is related to the volume of the tumor before surgery and the level of prolactin.