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肿瘤雌激素含量与子宫内膜癌的临床形态学及内分泌特征

Tumor estrogen content and clinico-morphological and endocrine features of endometrial cancer.

作者信息

Berstein L M, Tchernobrovkina A E, Gamajunova V B, Kovalevskij A J, Vasilyev D A, Chepik O F, Turkevitch E A, Tsyrlina E V, Maximov S J, Ashrafian L A, Thijssen J H H

机构信息

Lab. Oncoendocrinology, N.N. Petrov Research Institute of Oncology, Pesochny-2, 197758, St. Petersburg, Russia.

出版信息

J Cancer Res Clin Oncol. 2003 Apr;129(4):245-9. doi: 10.1007/s00432-003-0427-9. Epub 2003 Apr 15.

Abstract

OBJECTIVES

To compare estrogen concentrations in endometrial cancer tissue with those in macroscopically normal endometrium and with certain morphological characteristics of the tumor and endocrine parameters in patients.

METHODS

The estradiol content was evaluated by radioimmunoassay after homogenization and extraction in 78 adenocarcinomas (61 from postmenopausal patients).

RESULTS

Higher concentrations of estradiol in tumor tissue samples than in macroscopically normal endometrium were found in patients of both reproductive and postmenopausal age. This difference was the same in patients with either endometrial carcinoma type I or type II. No association between tumor steroid receptor levels, estradiol concentrations in blood serum, and timing of menopause with intratumoral estradiol contents was discovered. Estradiol concentrations in tumor tissues correlated positively with the clinical stage of disease and rate of tumor invasion (in patients with peripheric/lower type of fat topography), and negatively with tumor differentiation stage (in patients with central/upper type of fat topography) and the percentage of intact double-stranded DNA in normal endometrium.

CONCLUSIONS

Tumor estrogen content in endometrial cancer has clinical significance that is modified in the presence of certain endocrine characteristics related to insulin resistance. The role of local estrogen production (aromatase activity) in this setting deserves special study.

摘要

目的

比较子宫内膜癌组织中的雌激素浓度与大体正常子宫内膜中的雌激素浓度,以及患者肿瘤的某些形态学特征和内分泌参数。

方法

对78例腺癌(61例来自绝经后患者)进行匀浆和提取后,采用放射免疫分析法评估雌二醇含量。

结果

在生殖年龄和绝经后年龄的患者中,均发现肿瘤组织样本中的雌二醇浓度高于大体正常的子宫内膜。I型或II型子宫内膜癌患者的这种差异相同。未发现肿瘤类固醇受体水平、血清雌二醇浓度和绝经时间与肿瘤内雌二醇含量之间存在关联。肿瘤组织中的雌二醇浓度与疾病临床分期和肿瘤侵袭率(外周/下部脂肪分布类型的患者)呈正相关,与肿瘤分化阶段(中央/上部脂肪分布类型的患者)和正常子宫内膜中完整双链DNA的百分比呈负相关。

结论

子宫内膜癌中的肿瘤雌激素含量具有临床意义,在存在与胰岛素抵抗相关的某些内分泌特征时会发生改变。在这种情况下,局部雌激素产生(芳香化酶活性)的作用值得特别研究。

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