Schurz B
I. Universitäts-Frauenklinik, Wien.
Wien Klin Wochenschr Suppl. 1991;187:3-26.
From preclimacteric women (n = 10, 45-50 years of age) with gross cystic breast disease, levels of beta-endorphin, estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone, cortisol and prolactin were assayed radiochemically in the breast cyst fluid and in plasma. The beta-endorphin concentration (fmol/ml) was increased more than fourfold in the breast cyst fluid (17.6 +/- 4.6 SEM) than in plasma (4.2 +/- 0.5 SEM). In the breast cyst fluid, estradiol was increased 41-fold (1738.2 +/- 350.5 SEM pg/ml), and progesterone 47-fold (65.47 +/- 8.25 SEM ng/ml) more than in plasma. The significantly increased values of beta-endorphin, estradiol and progesterone in the breast cyst fluid and the identification of beta-endorphin in cyst-lining epithelia demonstrate the local synthesis. Growth factor-like properties of beta-endorphin and estradiol are accountable for the propagation of cystic changes. The autonomic formation and function of beta-endorphin, estradiol and progesterone in cyst compartments can not be related with the levels of luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone and cortisol, which were significantly higher in plasma than in the breast cyst fluid. In the breast cyst fluid, prolactin could not detected to be significantly higher than in plasma. In addition the plasma-concentration of testosterone, androstenedione, thyroxin, triiodothyronine, thyroid-binding globulin, sexual-hormone-binding-globulin could be detected within the normal range. In this study we could demonstrate the synergism of beta-endorphin, steroid hormones and peptide hormones which advance the growth of gross cystic disease of preclimacteric women. Beta-endorphin was also examined by immunocytochemical assays (fluorescence, alkaline phosphatase and horseradish peroxidase method), in 11 women with pure fibrocystic disease, in 7 women with fibrocystic disease combined with a carcinoma in situ and in 15 women with fibrocystic disease combined with invasive carcinoma of the breast. Sections of frozen and paraffin embedded tissue of the same patient were reacted with anti-beta-endorphin antiserum. The immunoreactivity of beta-endorphin was intense in normal, proliferative altered and cyst-lining epithelia of fibrocystic disease and decreased in atypical epithelia and carcinoma cells of the breast. The degree of beta-endorphin staining is related to the degree of cell differentiation. In addition, nuclear receptors for estrogen and progesterone were assayed by peroxidase antiperoxidase technique.(ABSTRACT TRUNCATED AT 400 WORDS)
对患有乳腺大囊性病的绝经前女性（n = 10，年龄45 - 50岁），采用放射化学法检测其乳腺囊肿液和血浆中β-内啡肽、雌二醇、孕酮、促黄体生成素、促卵泡激素、促甲状腺激素、皮质醇和催乳素的水平。乳腺囊肿液中β-内啡肽浓度（fmol/ml）比血浆（4.2 ± 0.5 SEM）增加了四倍多（17.6 ± 4.6 SEM）。在乳腺囊肿液中，雌二醇比血浆增加了41倍（1738.2 ± 350.5 SEM pg/ml），孕酮增加了47倍（65.47 ± 8.25 SEM ng/ml）。乳腺囊肿液中β-内啡肽、雌二醇和孕酮显著升高的值以及在囊肿内衬上皮中鉴定出β-内啡肽，证明了其局部合成。β-内啡肽和雌二醇的生长因子样特性是囊肿性变化增殖的原因。囊肿隔室内β-内啡肽、雌二醇和孕酮的自主形成和功能与促黄体生成素、促卵泡激素、促甲状腺激素和皮质醇水平无关，这些激素在血浆中的水平显著高于乳腺囊肿液。在乳腺囊肿液中，未检测到催乳素显著高于血浆。此外，睾酮、雄烯二酮、甲状腺素、三碘甲状腺原氨酸、甲状腺结合球蛋白、性激素结合球蛋白的血浆浓度在正常范围内。在本研究中，我们证明了β-内啡肽、甾体激素和肽类激素的协同作用促进了绝经前女性乳腺大囊性病的生长。还采用免疫细胞化学分析法（荧光、碱性磷酸酶和辣根过氧化物酶法）对11例单纯纤维囊性疾病女性、7例纤维囊性疾病合并原位癌女性和15例纤维囊性疾病合并乳腺浸润癌女性进行了β-内啡肽检测。同一患者的冷冻和石蜡包埋组织切片与抗β-内啡肽抗血清反应。β-内啡肽在纤维囊性疾病的正常、增殖改变和囊肿内衬上皮中的免疫反应性强烈，在乳腺非典型上皮和癌细胞中降低。β-内啡肽染色程度与细胞分化程度相关。此外，采用过氧化物酶抗过氧化物酶技术检测雌激素和孕酮的核受体。（摘要截断于400字）
