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目的探讨米非司酮对子宫肌瘤和内膜组织Ki67基因、MMP2基因、Fas基因表达的影响。方法 62例子宫肌瘤患者随机分为对照组24例和治疗组38例,治疗组患者从月经周期第2~3d开始,每日服用25mg米非司酮,连续服用1个月后行子宫手术;对照组病人入院后不服用任何药物,直接手术,术中均取瘤体及内膜组织。用免疫组化SP法检测子宫肌瘤及内膜组织中Ki67、MMP2、Fas基因的表达水平。结果治疗组子宫肌瘤组织Fas阳性率为55.3%,明显高于对照组的29.2%,差异有统计学意义(P<0.05);治疗组子宫肌瘤Ki67的阳性表达率为36.8%,明显低于对照组的70.8%,差异有统计学意义(P<0.01);治疗组子宫肌瘤MMP2的阳性表达率为36.8%,明显低于对照组的66.7%,差异均有统计学意义(P<0.05);但两组子宫内膜组织中Ki67、MMP2和Fas的表达没有显著变化,差异均无统计学意义(P均大于0.05)。结论米非司酮抑制子宫肌瘤细胞的增殖和侵袭转移,促进肌瘤细胞凋亡,这可能是米非司酮治疗子宫肌瘤的作用机理。
Objective To investigate the effects of mifepristone on the expression of Ki67, MMP2 and Fas genes in uterine fibroids and endometrium. Methods Totally 62 patients with uterine fibroids were randomly divided into control group (24 cases) and treatment group (38 cases). The patients in treatment group started daily menstruation from the 2nd to the 3rd day and took 25 mg mifepristone daily for 1 month. Uterine surgery ; Patients in the control group did not take any drugs after admission, and received direct surgery and tumor and endometrial tissues. Immunohistochemical SP method was used to detect the expression of Ki67, MMP2 and Fas in uterine fibroids and endometrial tissues. Results The positive rate of Fas in uterine leiomyoma was 55.3% in treatment group, which was significantly higher than that in control group (29.2%, P <0.05). The positive rate of Ki67 expression in uterine fibroids was 36.8% in treatment group (P <0.01). The positive expression rate of MMP2 in the treatment group was 36.8%, which was significantly lower than that in the control group (66.7%, P <0.01), the difference was statistically significant (P < 0.05). However, the expression of Ki67, MMP2 and Fas in the two groups had no significant difference (P> 0.05). Conclusion Mifepristone inhibits the proliferation, invasion and metastasis of uterine leiomyoma cells and promotes the apoptosis of fibroids, which may be the mechanism of mifepristone treatment of uterine fibroids.