Atalay C, Kanliöz M, Altinok M
Department of General Surgery, Ankara Oncology Hospital, Turkey.
Neoplasma. 2002;49(4):278.
Hormone receptors in normal breast tissue were reported to be under the influence of cyclic variations of serum hormones during the menstrual cycle. The current study aimed to demonstrate a similar relationship between the phase of the menstrual cycle and hormone receptor status in operable, premenopausal patients with breast cancer. Patients were prospectively categorized according to the first day of last menstrual period into clinically defined follicular/luteal, perimenstrual/mid-cycle and unopposed estrogen/rest of the cycle phases and hormonally defined follicular/luteal phases. Serum follicle-stimulating hormone, luteinizing hormone, estrogen and progesterone levels were determined on the day of the operation. Estrogen and progesterone receptors in the tissues were detected by immunohistochemistry. Eighty-eight consecutive premenopausal patients with breast cancer were included in the study. Estrogen and progesterone receptors were positive in 57 (64.8%) and 40 (70.2%) patients respectively. Forty-nine patients were in follicular, and 39 patients in luteal phases according to serum hormone levels. Estrogen receptor positivity was significantly higher in hormonally defined follicular phase (p=0.025) and also had a tendency to be higher in perimenstrual phase (p=0.048). In contrast, progesterone receptor status was found to be independent of the phases of the menstrual cycle. As a conclusion, hormone receptor status might change during different phases of the menstrual cycle due to a possible effect of the circulating hormones and if it is found as negative, should he re-evaluated concerning the phase of the menstrual cycle in which the operation was performed.
据报道,正常乳腺组织中的激素受体受月经周期中血清激素周期性变化的影响。本研究旨在证明在可手术的绝经前乳腺癌患者中,月经周期阶段与激素受体状态之间存在类似的关系。根据末次月经的第一天,将患者前瞻性地分为临床定义的卵泡期/黄体期、围经期/月经中期以及无对抗雌激素期/月经周期其余阶段,以及激素定义的卵泡期/黄体期。在手术当天测定血清促卵泡生成素、促黄体生成素、雌激素和孕激素水平。通过免疫组织化学检测组织中的雌激素和孕激素受体。88例连续的绝经前乳腺癌患者纳入本研究。雌激素和孕激素受体阳性患者分别为57例(64.8%)和40例(70.2%)。根据血清激素水平,49例患者处于卵泡期,39例患者处于黄体期。激素定义的卵泡期雌激素受体阳性率显著更高(p=0.025),围经期也有升高趋势(p=0.048)。相比之下,孕激素受体状态与月经周期阶段无关。结论是,由于循环激素的可能作用,激素受体状态可能在月经周期的不同阶段发生变化,如果发现为阴性,应根据手术时所处的月经周期阶段重新评估。