摘要
目的研究他莫昔芬对乳腺癌患者的子宫内膜腺细胞p21ras蛋白表达的影响,探讨ras基因突变与他莫昔芬相关性子宫内膜病变的发生、发展的关系。方法对2005年1月~2008年10月于温州医学院附属第二医院乳腺外科手术绝经后乳腺癌患者进行随访,用免疫组化(sp法)检测服用他莫昔芬前和服用3年以上的正常子宫内膜和他莫昔芬相关性子宫内膜息肉中的p21ras蛋白表达。以同时期于我院治疗的绝经后子宫脱垂患者的子宫内膜、绝经后子宫内膜息肉,及子宫内膜癌患者为对照组。所有对照组患者,均无化疗和放疗及雌、孕激素服用史。结果乳癌组中,服药3年以上和他莫昔芬相关子宫内膜息肉组中,p21ras的表达率分别为25.5%(5/20)、27.27%(6/22),与正常未服药的内膜及子宫内膜癌组比较,差别有统计学意义。在对照组中,p21ras在正常内膜组、内膜息肉组、子宫内膜癌组阳性表达率分别为3.33%(1/30)、13.33%(4/30)、70%(14/20),表达率逐渐增加,有统计学意义。结论 p21ras蛋白在子宫内膜腺细胞上的过度表达与子宫内膜病变关系密切。使用他莫昔芬后,引起的p21ras蛋白的表达增加,可能是这一人群子宫内膜癌发病率增高的主要原因。
Objective To investigate the expression of p21ras in endometrium of postmenopausal women taking tamoxifen（TAM） for breast cancer,and study the relationship between ras mutation and tamoxifen-related endometrial lesion.Methods A prospective study was performed in 85 cases of breast cancer patients who had operation in the 2nd Affiliated Hospital of Wenzhou medical college from January 2005 to October 2008.Endometrial tissues were taken from the breast cancer patients and diagnosed and grouped through HE,including 20 cases of normal endometrium before TAM treatment,20 cases of normal endometrium after over 3 years of TAM treatment and 22 cases of endometrial polyps after TAM treatment.Eighty cases of postmenopausal patients were rolled as control group,including 30 cases of normal endometrial tissue from prolapse uterus,30 cases of non-Tamoxifen-treated polyps and 20 cases of adenocarcinoma of endometrium.Immunohistochemistry（sp） was used to detect the p21ras in these tissues.Results In breast cancer group,the positive rate of p21ras expression in tamoxifen-treated endometrium and polyps were 25.5%（5/20） and 27.27%（6/22） respectively.Comparing with the non-tamoxifen-treated endometrium and adenocarcinoma of endometrium,the difference was significant（P0.05）.In control group,the positive rate of p21ras expression in normal endometrium,endometrial polyps and adenocarcinoma of endometrium were 3.33%（1/30）,13.33%（4/30）,70%（14/20）respectively.A progressive increase was along with the grade of the lesion（P0.05）.Conclusion The overexpression of p21ras in endometrium had close relation with endometrial lesion.Taking tamoxifen may cause the overexpression of p21ras,which may be a possible reason of the development of endometrial carcinoma in postmenopausal women who have been treated with TAM.
出处
《医学研究杂志》
2011年第4期92-95,共4页
Journal of Medical Research
基金
温州市科技局科研基金资助项目(Y20060149
2009S0158)
