雌激素受体亚型在肥大乳房乳腺组织中的表达及意义
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摘要
目的测定雌激素受体亚型α和β(ERα和ERβ)在肥大乳房乳腺组织中和正常体积乳房乳腺组织中的表达情况,探讨其在乳房肥大发病机制中的作用和意义.
方法采用免疫组织化学EnVision二步法,研究38例肥大乳房和17例正常体积乳房中ERα和ERβ的表达情况,并对结果进行统计学分析,比较两种雌激素受体亚型在肥大乳房与正常乳房中的表达是否存在差异,并进一步研究了青春期肥大乳房(20例)与妊娠后肥大乳房(18例)中两种亚型的表达情况。所有标本均送普通病理学检查。
结果ERα多数表达于细胞核,仅见于腺上皮细胞。ERα在肥大乳房和正常体积乳房中的阳性表达分别为97.37℅和76.47℅,两者比较有显著性差异(P<0.05),青春期肥大乳房与妊娠后肥大乳房的阳性表达分别为95℅和100℅,两者比较无显著性差异(P>0.05)。ERβ多见细胞核和细胞浆同时表达,可见于腺上皮细胞、间质细胞、肌上皮细胞及淋巴细胞。ERβ在肥大乳房和正常体积乳房中的阳性表达分别为89.47℅和100℅,两者比较无显著性差异(P>0.05),青春期肥大乳房与妊娠后肥大乳房中的阳性表达分别为90℅和88.89℅,两者比较无显著性差异(P>0.05)。
结论1、青春期乳房肥大与妊娠后乳房肥大的发生均与乳腺组织中ERα含量升高有关。2、青春期乳房肥大与妊娠后乳房肥大的发生与ERβ无明显相关性,即两者的发生均是ERα含量增高的正性作用,而非ERβ含量降低的结果。3、青春期乳房肥大和妊娠后乳房肥大的发生机理无本质上的区别。妊娠可能是乳房肥大的一个潜在因素。
Objective To detect the expression of the estrogen receptor(ER) isoforms(ERαand ERβ)in the mammary gland of the hypertrophic breast and the normal voluminal breast,so that their function and significance in the pathogenesis of breast hypertrophy can be investigated.
Method The breast tissue samples were obtained,including hypertrophic breast tissue(38 cases) and normal voluminal breast tissue(17 cases).They were detected by the EnVision two step method immunohistochemistry for the expression of ERαand ERβ,and took statistical analysis to compare their difference.The pubertal hypertrophic breast and the postpartum hypertrophic breast were also compared. All the tissues were examined by pathology.
Results ERαwas expressed only in the cell nucleus mostly,and mainly in the breast epithelioglandulars.The positive expression rate of ERαin the hypertrophic breast was 97.37℅,while 76.47℅ in the normal voluminal breast,showing a significant difference between the two groups(P<0.05). The positive expression rates of ERαin the pubertal hypertrophic breast and the postpartum hypertrophic breast were 95℅and 100℅,and there was no significance between the two groups in a statistics basis(P>0.05). ERβwas expressed in both cytoplasm and nucleus,and it was expressed in many cell types,such as epithelioglandulars,stroma cells,myoepithelial cells and lymphocytes. The positive expression rates of ERβin the hypertrophic breast and normal voluminal breast were 89.47℅ and 100℅,and showing no significant difference between them(P>0.05).So did the pubertal hypertrophic breast and the postpartum hypertrophic breast.
Conclusions The development of hypertrophic breast may be related to the excessive expression of ERαin the breast tissue,while the relationship between the hypertrophic breast and ERβmay be not obvious,and pregnancy may be an underlying factor of Hypertrophy of breast.
方法采用免疫组织化学EnVision二步法,研究38例肥大乳房和17例正常体积乳房中ERα和ERβ的表达情况,并对结果进行统计学分析,比较两种雌激素受体亚型在肥大乳房与正常乳房中的表达是否存在差异,并进一步研究了青春期肥大乳房(20例)与妊娠后肥大乳房(18例)中两种亚型的表达情况。所有标本均送普通病理学检查。
结果ERα多数表达于细胞核,仅见于腺上皮细胞。ERα在肥大乳房和正常体积乳房中的阳性表达分别为97.37℅和76.47℅,两者比较有显著性差异(P<0.05),青春期肥大乳房与妊娠后肥大乳房的阳性表达分别为95℅和100℅,两者比较无显著性差异(P>0.05)。ERβ多见细胞核和细胞浆同时表达,可见于腺上皮细胞、间质细胞、肌上皮细胞及淋巴细胞。ERβ在肥大乳房和正常体积乳房中的阳性表达分别为89.47℅和100℅,两者比较无显著性差异(P>0.05),青春期肥大乳房与妊娠后肥大乳房中的阳性表达分别为90℅和88.89℅,两者比较无显著性差异(P>0.05)。
结论1、青春期乳房肥大与妊娠后乳房肥大的发生均与乳腺组织中ERα含量升高有关。2、青春期乳房肥大与妊娠后乳房肥大的发生与ERβ无明显相关性,即两者的发生均是ERα含量增高的正性作用,而非ERβ含量降低的结果。3、青春期乳房肥大和妊娠后乳房肥大的发生机理无本质上的区别。妊娠可能是乳房肥大的一个潜在因素。
Objective To detect the expression of the estrogen receptor(ER) isoforms(ERαand ERβ)in the mammary gland of the hypertrophic breast and the normal voluminal breast,so that their function and significance in the pathogenesis of breast hypertrophy can be investigated.
Method The breast tissue samples were obtained,including hypertrophic breast tissue(38 cases) and normal voluminal breast tissue(17 cases).They were detected by the EnVision two step method immunohistochemistry for the expression of ERαand ERβ,and took statistical analysis to compare their difference.The pubertal hypertrophic breast and the postpartum hypertrophic breast were also compared. All the tissues were examined by pathology.
Results ERαwas expressed only in the cell nucleus mostly,and mainly in the breast epithelioglandulars.The positive expression rate of ERαin the hypertrophic breast was 97.37℅,while 76.47℅ in the normal voluminal breast,showing a significant difference between the two groups(P<0.05). The positive expression rates of ERαin the pubertal hypertrophic breast and the postpartum hypertrophic breast were 95℅and 100℅,and there was no significance between the two groups in a statistics basis(P>0.05). ERβwas expressed in both cytoplasm and nucleus,and it was expressed in many cell types,such as epithelioglandulars,stroma cells,myoepithelial cells and lymphocytes. The positive expression rates of ERβin the hypertrophic breast and normal voluminal breast were 89.47℅ and 100℅,and showing no significant difference between them(P>0.05).So did the pubertal hypertrophic breast and the postpartum hypertrophic breast.
Conclusions The development of hypertrophic breast may be related to the excessive expression of ERαin the breast tissue,while the relationship between the hypertrophic breast and ERβmay be not obvious,and pregnancy may be an underlying factor of Hypertrophy of breast.
引文
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5.孙家明,乔群,戚可名。肥大乳房和小乳房乳腺组织中雌激素受体的表达[J]。中华整形外科杂志,2004,20(6):416-418。
6. Hawkins MB,Thomton JW,Crews D,Skipper JK,Dotte A,Thomas P.Identification of a third distinct estrogen receptor and reclassification of estrogen receptors in teleosts.Proc Natl Acad Sci U.S.A,2000,97(20):10751-10756.
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9. Paech K, Webb P,Kuiper GG,Nilsson S,Gustafsson J,Kushner PJ,et al.Differential ligand activation of estrogen receptors ERalpha and ERbeta at AP1 sites.Science,1997,277(5331):1508-1510.
10. Hanstein B, Liu H, Yancisin MC, Brown M. Functional analysis of a novel estrogen receptor-beta isoform.Mol Endocrinol JT-Molecular endocrimology(Baltimore,Md),1999,13(1):129-137.
11. Hall JM, McDonnell DP. The estrogen receptor beta-isoform(ERbeta) of the human estrogen receptor modulates Eralpha transcriptional activity and is a key regulator of the cellular response to estrogens and antiestrogens.Endocrinology,1999,140(12):5566-5578.
12. Weihua Z,Saji S,Makinen S,Cheng G,Jensen EV,Warner M,et la.Estrogen receptor(ER) beta,a modulator of Eralpha in the uterus.Proc Natl Acad Sci U.S.A,2000,97(11):5936-5941.
13. Arscott GD,Craig HR,Gabay L.Failure of bromocriptine therapy to control juvenile mammary hypertrophy[J].Br J Plast Surg,2001,54(8):720-723.
14. Baker SB,Burkey BA,Thornton P,et al. Juvenile gigantomastia: presentation of four cases and review of the literature[J]. Ann Plast Surg,2001,46(5):517-525.
15.乔群,凌诒淳,周刚等。中国125名青年女性乳房体积测量。中华整形烧伤外科杂志,1991,7(1):1-4。
16. Brown RW,Cheng YC,Kurlay M.A formula for surgical modification of the breast.Plast Reconstr Surg,2000,106:1342-1345.
17.韩文雅,赵天兰,张永胜,等。雌、孕激素受体与各类型巨乳发生发展的关系。苏州大学学报(医学版),2009,29(2):318-320.
18.张芾男,滕利,杨锴,等。青春期乳房肥大症乳腺组织中雌激素受体的表达.中国美容医学,2007,16(2):156-158.
19.徐鹰妮,姜军,程鸿等。ERα和ERβ在不同类型乳腺组织的表达及其意义。第三军医大学报,2007,29(11):1093-1095。
20. Gliosci A, Presutti F. Virginal gigantomastia: validity of combined surgical and hormonal treatments. Aesthetic Plast Surg,1993,17(1):61-65.
21. Kulkarni D, Beechey-Newman N, Hamed H, et al. Gigantomastia: A problem of local recurrence. Breast, 2006 ,15(1):100-102.
22.王殊,王杉,张嘉庆,乔新民等。雌激素受体亚型在人乳腺癌的表达及意义。中华外科杂志,2004,42(13):792-794。
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2. Morimoto T, Komaki K, Mori T, et al. Juvenile gigantomastia:report of a case[J]. Surg Today, 1993,23(3):260-264.
3. Noczynska A, Wasikowa R, Myczkowski T. Hypersensitivity of estrogen receptors as a cause of gigantomasty in two girls [J].Pol Merkuriusz Lek, 2001,11(66):507-509.
4.秦映芬,沈寒蕾,黄松,等。巨乳症的临床与病理学观察[J]。临床与实验病理学杂志,2004,20(3):292-294。
5.孙家明,乔群,戚可名。肥大乳房和小乳房乳腺组织中雌激素受体的表达[J]。中华整形外科杂志,2004,20(6):416-418。
6. Hawkins MB,Thomton JW,Crews D,Skipper JK,Dotte A,Thomas P.Identification of a third distinct estrogen receptor and reclassification of estrogen receptors in teleosts.Proc Natl Acad Sci U.S.A,2000,97(20):10751-10756.
7. Nilsson S,Makela S,Treuter E,Tujague M,Thomsen J,Andersson G,et al.Mechanisms of estrogen action.Physiol Rev,2001,81(4):1535-1565.
8. Lee YR,Park J,Yu HN,Kim JS,Youn HJ, Jung SH.Up-regulation of PI3K/Akt signaling by 17beta-estradiol through activation of estrogen receptor-alpha,but not estrogen receptor-beta,and stimalates cell growth in breast cancer cells.Biochem Biophys Res commun,2005,336(4):1221-1226.
9. Paech K, Webb P,Kuiper GG,Nilsson S,Gustafsson J,Kushner PJ,et al.Differential ligand activation of estrogen receptors ERalpha and ERbeta at AP1 sites.Science,1997,277(5331):1508-1510.
10. Hanstein B, Liu H, Yancisin MC, Brown M. Functional analysis of a novel estrogen receptor-beta isoform.Mol Endocrinol JT-Molecular endocrimology(Baltimore,Md),1999,13(1):129-137.
11. Hall JM, McDonnell DP. The estrogen receptor beta-isoform(ERbeta) of the human estrogen receptor modulates Eralpha transcriptional activity and is a key regulator of the cellular response to estrogens and antiestrogens.Endocrinology,1999,140(12):5566-5578.
12. Weihua Z,Saji S,Makinen S,Cheng G,Jensen EV,Warner M,et la.Estrogen receptor(ER) beta,a modulator of Eralpha in the uterus.Proc Natl Acad Sci U.S.A,2000,97(11):5936-5941.
13. Arscott GD,Craig HR,Gabay L.Failure of bromocriptine therapy to control juvenile mammary hypertrophy[J].Br J Plast Surg,2001,54(8):720-723.
14. Baker SB,Burkey BA,Thornton P,et al. Juvenile gigantomastia: presentation of four cases and review of the literature[J]. Ann Plast Surg,2001,46(5):517-525.
15.乔群,凌诒淳,周刚等。中国125名青年女性乳房体积测量。中华整形烧伤外科杂志,1991,7(1):1-4。
16. Brown RW,Cheng YC,Kurlay M.A formula for surgical modification of the breast.Plast Reconstr Surg,2000,106:1342-1345.
17.韩文雅,赵天兰,张永胜,等。雌、孕激素受体与各类型巨乳发生发展的关系。苏州大学学报(医学版),2009,29(2):318-320.
18.张芾男,滕利,杨锴,等。青春期乳房肥大症乳腺组织中雌激素受体的表达.中国美容医学,2007,16(2):156-158.
19.徐鹰妮,姜军,程鸿等。ERα和ERβ在不同类型乳腺组织的表达及其意义。第三军医大学报,2007,29(11):1093-1095。
20. Gliosci A, Presutti F. Virginal gigantomastia: validity of combined surgical and hormonal treatments. Aesthetic Plast Surg,1993,17(1):61-65.
21. Kulkarni D, Beechey-Newman N, Hamed H, et al. Gigantomastia: A problem of local recurrence. Breast, 2006 ,15(1):100-102.
22.王殊,王杉,张嘉庆,乔新民等。雌激素受体亚型在人乳腺癌的表达及意义。中华外科杂志,2004,42(13):792-794。
23. Agarwal N,Kriplani A,Gupta A,et al.Management of gigantomastia complicating pregnancy.A case report[J].J Reprod Med,2002,47(10):871-874.
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