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目的:通过研究绝经期雌、孕激素受体在子宫全层中的表达,比较它们在子宫内膜、浅肌层、深肌层和浆膜层中的梯度分布情况,为乳腺癌术后在去除子宫内膜的情况下可否安全地服用他莫昔芬寻找理论依据。方法:选择因子宫脱垂需行子宫全切术的绝经期患者,在相同的宫体部位分别取子宫体的全层组织,用免疫组织化学法研究不同病症中雌、孕激素受体在子宫全层(内膜层、浅肌层、深肌层及浆膜层)中的表达情况,采用LeicaQ500IW图像分析仪和Olympus光学显微镜进行测定,对雌、孕激素受体阳性细胞的表达率进行比较。结果:雌、孕激素受体在绝经期子宫内膜层中高度表达,与其他各层比较,差异有统计学意义(P=0.001);浆膜层含量最少,与其他各层比较,差异有统计学意义(P=0.000);浅肌层与深肌层之间比较,差异无统计学意义(P=0.148)。结论:绝经期雌、孕激素水平急剧下降,子宫各层中雌、孕激素受体含量较低,但在子宫内膜中仍占多数,故绝经期乳腺癌妇女长期服用他莫昔芬会引起子宫内膜病变,剥除子宫内膜后,破坏了大部分雌、孕激素受体,可以安全、有效地长期服用他莫昔芬。
OBJECTIVE: To study the distribution of estrogen and progesterone receptors in the uterus of postmenopausal women and to compare their gradient distribution in the endometrium, superficial myometrium, deep muscularis and serosa, Taken safely for tamoxifen to find the rationale for removing the endometrium. Methods: To choose the uterus hysterectomy due to uterine total menopause patients, respectively, in the same part of the uterus body were taken from the full-thickness tissue, immunohistochemical study of different disorders in estrogen and progesterone receptors in the uterus Full-thickness (intima-layer, superficial myometrium, deep muscularis and serosal) expression were compared with Leica Q500IW image analyzer and Olympus optical microscope to compare the expression rates of estrogen and progesterone receptor-positive cells . Results: The estrogen and progesterone receptors were highly expressed in the endometrial layer of menopause. The difference was statistically significant (P = 0.001) compared with other layers. The serosal layer content was the least. Compared with other layers, there were significant differences Statistical significance (P = 0.000). There was no significant difference between superficial myometrium and superficial myometrium (P = 0.148). Conclusion: The levels of estrogen and progesterone in menopause decline sharply, and the levels of estrogen and progesterone receptors in the uterine layers are lower but remain the majority in the endometrium. Therefore, long-term use of tamoxifen in women with menopausal breast cancer will cause Endometrial lesions, stripping the endometrium, destroyed the majority of estrogen and progesterone receptors, safe, effective long-term use of tamoxifen.