Wang H, Jin J
Department of Obstetrics and Ggnecology, Beijing Friendship Hospital, the Capital Medical University, Beijing 100050, China.
Zhonghua Fu Chan Ke Za Zhi. 2000 Feb;35(2):79-81.
To study the effects of mifepristone on estrogen receptors (ER) and progestin receptors (PR) in human uterine leiomyoma and myometrium.
20 patients with uterine leiomyoma who had surgical indication received 25 mg of mifepristone daily for 90 days beginning on the first day of menstrual cycle. Ultrasound examination, serum hormonal parameters, liver and renal function, electrolyte, complete blood count were monitored prior to and at the end of treatment. Hysterectomy or myomectomy was performed just when the treatment finished. Leiomyomata and myometrial tissue were obtained for immunohistochemical ER and PR analyses using monoclonal antibody. Control group included 20 patients who had matched age, weight, size and position of leiomyoma, and operated in the follicular phase of the cycle.
After 90 days of mifepristone treatment, the leiomyoma volume decreased by (37.3 +/- 19.0)% and the uterine volume decreased (27.4 +/- 21.9)%. Hormonal parameters were within the levels of follicular phase. ER and PR positive rate in leiomyoma but not in myometrium of study group were significantly less than those of control group (P < 0.001). The positive rate of ER and PR of control group and PR of study group in leiomyoma were significantly higher than those in myometrial tissue of both groups (P < 0.05). ER of study group in leiomyoma was similar to myometrial tissue (P > 0.05).
Mifepristone is a safe and effective drug for treating uterine leiomyoma. It can significantly decrease ER and PR in leiomyoma but not in myometrial tissue.
研究米非司酮对人子宫平滑肌瘤及子宫肌层中雌激素受体(ER)和孕激素受体(PR)的影响。
20例有手术指征的子宫平滑肌瘤患者,从月经周期的第一天开始,每日服用25mg米非司酮,共90天。在治疗前及治疗结束时监测超声检查、血清激素参数、肝肾功能、电解质、血常规。治疗结束后立即行子宫切除术或肌瘤切除术。获取平滑肌瘤和子宫肌层组织,使用单克隆抗体进行免疫组化ER和PR分析。对照组包括20例年龄、体重、平滑肌瘤大小和位置相匹配且在月经周期卵泡期手术的患者。
米非司酮治疗90天后,平滑肌瘤体积减少(37.3±19.0)%,子宫体积减少(27.4±21.9)%。激素参数处于卵泡期水平。研究组平滑肌瘤中ER和PR阳性率显著低于对照组(P<0.001),而子宫肌层中ER和PR阳性率无显著差异。对照组平滑肌瘤中ER和PR阳性率以及研究组平滑肌瘤中PR阳性率均显著高于两组子宫肌层组织(P<0.05)。研究组平滑肌瘤中ER与子宫肌层组织相似(P>0.05)。
米非司酮是治疗子宫平滑肌瘤的一种安全有效的药物。它能显著降低平滑肌瘤中的ER和PR,但对子宫肌层组织无影响。