摘要
目的 :观察射频治疗子宫肌瘤后组织的病理改变和雌孕激素受体 (ER、PR)表达的情况 ,探讨射频治疗子宫肌瘤的机制。方法 :30例多发性子宫肌瘤患者 ,分别采用 0 .5cm、1.2cm长的射频刀行射频治疗 ,2 8例治疗后立即切除子宫 ,2例 3d后切除子宫 ,于消融灶中心 (A组 )、边缘 (B组 )、边缘外 1cm(C组 )、边缘外 2cm(D组 )处取材 ,HE染色下观察病理变化 ,免疫组化检测ER、PR水平 ;选同一患者子宫上未做射频治疗的肌瘤作为对照组。结果 :射频治疗后 ,消融灶中心肌瘤组织呈凝固性坏死 ,ER、PR无表达 ;消融灶边缘肌瘤细胞变性 ,ER、PR表达减少 (P <0 .0 5 ) ;消融灶边缘外 1cm ,肌瘤细胞无变性、坏死 ,但ER、PR表达仍低于对照组 (P <0 .0 5 ) ;消融灶边缘外2cm ,ER、PR与对照组相比差异无显著性 (P >0 .0 5 )。结论 :使肌瘤组织凝固性坏死 ,ER、PR低表达是射频治疗子宫肌瘤的机制之一。
Objectives To observe the pathological features and expression of estrogen receptor(ER) and progestin receptor (PR) in human uterine leiomyoma after radiofrequency ablation(RFA) in order to find out its mechanism.Methods 30 patients with uterine leiomyoma were treated with 0.5 cm or 1.2 cm long RFA electrodes . Hysterectomy was performed in 28 cases just when the RFA treatment finished and in 2 patients after 3 days of RFA treatment. Specimens were obtained from the center tissue of ablation(group A), marginal tissue of the ablation(group B), tissues of 1cm far from the margin (group C), and tissues of 2cm far from the margin(group D) for immunohistochemical ER and PR analyses. All of the specimens were stained with hematoxylin-eosion for pathologic examination. Specimens obtained from untreated leiomyoma in the same uterine served as control group.Results Pathologic section of a leiomyoma RFA lesion reveals a sharply demarcated area of coagulative necrosis.There was no expression of ER and PR in group A. ER and PR optical density in group B and group C was significantly less than that of control group( P <0.05), but that of group D is similar to control group( P >0.05).Conclusions It is an important mechanism that RFA inducing coagulative necrosis and the lower expression of ER and PR in hysteromyoma could treat uterine leiomyoma.
出处
《郧阳医学院学报》
2002年第5期257-260,共4页
Journal of Yunyang Medical College
关键词
射频消融
子宫肌瘤
病理学
雌激素受体
孕酮受体
治疗
radiofrequency ablation
uterine leiomyoma
pathology
receptors,estrogen
receptors,progesterone
