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目的研究原发性肝癌雌激素受体(ER)的表达及内分泌治疗的临床价值.方法应用Lee氏荧光配体细胞化学法检测41例手术病理确诊的原发性肝癌ER的表达.本组男38例,女3例,年龄25岁~72岁.同时检测肝癌的组织类型、分化程度、肿瘤大小、血清AFP及CEA.6例ER阳性者采用他莫昔芬治疗(每次20mg,2次/d,长期服用)并观察疗效.结果肝癌组织ER阳性20/41例,阳性率488%.ER阳性率与患者年龄、性别、AFP、CEA含量及组织类型(梁状型ER阳性450%,腺样型333%,实体型714%,硬化型667%,透明细胞型250%;P>005)无明显关系,与肿瘤体积(≥10cm,ER阳性率750%;<10cm,ER阳性238%;P<001)和分化程度(分化好26例,ER阳性346%;分化差15例,ER阳性733%;P<005)有显著关系.本组ER阳性病例中6例经他莫昔芬内分泌治疗有效5/6(833%),其中4例AFP下降.结论ER阳性肝细胞癌患者进行内分泌治疗有一定疗效
5. Objective To study the clinical value of estrogen receptor (ER) expression and endocrine therapy in primary liver cancer. Methods The expression of ER in 41 cases of primary hepatic carcinoma confirmed by pathology was detected by Lee’s fluorescence ligand cytochemistry. The group of 38 males and 3 females, aged 25 to 72 years old. At the same time, the histological type, differentiation, tumor size, serum AFP and CEA were detected. 6 cases of ER-positive were treated with tamoxifen (20mg each time, 2 times / d, long-term use) and observed efficacy. Results The positive rate of ER was 20/41, and the positive rate was 48.8%. ER positive rate and patient age, gender, AFP, CEA content and tissue type (beam-type ER-positive 45 0%, adenoid type 33 3%, solid type 71 4%, hardening type 66 7%, transparent Cell type 250%; P>005) No significant relationship with tumor volume (≥10cm, ER positive rate 750%; <10cm, ER positive 238%; P<001) and differentiation The degree (differentiated well in 26 cases, ER positive 34 6%; poor differentiation in 15 cases, ER positive 73 3%; P <0 05) had a significant relationship. Of the ER-positive cases in this group, 6 cases were treated with Tamoxifen endocrine therapy 5/6 (83. 3%), of which 4 cases of AFP decreased. Conclusions Endocrine therapy is effective in patients with ER-positive hepatocellular carcinoma