睾酮和雌激素治疗对绝经后妇女子宫内膜性激素受体分布的影响。
Effects of testosterone and estrogen treatment on the distribution of sex hormone receptors in the endometrium of postmenopausal women.
作者信息
Zang Hong, Sahlin Lena, Masironi Britt, Hirschberg Angelica Lindén
机构信息
Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
出版信息
Menopause. 2008 Mar-Apr;15(2):233-9. doi: 10.1097/gme.0b013e318148bb99.
OBJECTIVE
Our aim was to investigate the effects of the addition of testosterone to estrogen compared with those of estrogen alone on the expression and distribution of sex hormone receptors in glands and stroma of the endometrium of postmenopausal women.
DESIGN
An open, randomized clinical study with parallel group comparison was performed in the Women's Health Research Unit at a university hospital. Thirty-one postmenopausal women were given oral estradiol valerate (2 mg daily) or estradiol valerate in combination with testosterone undecanoate (40 mg every 2 days) for 3 months. Before and at the end of treatment, endometrial biopsy samples were obtained, and expressions of estrogen receptor (ER)-alpha, ER-beta, progesterone receptor isoforms A and B, and androgen receptor (AR) were evaluated by immunohistochemical analysis.
RESULTS
At baseline, expressions of ER-alpha and progesterone receptors were stronger in glands than in stroma, whereas the immunostaining of AR was stronger in stroma than in glands. After treatment, expressions of ER-alpha and progesterone receptors were up-regulated in both glands and stroma by both treatments, but to a lesser extent in glands by combined treatment. The expression of ER-beta in glands was significantly higher with combined treatment than with estrogen alone. Moreover, AR immunostaining was significantly higher after combined treatment than after treatment with estrogen alone.
CONCLUSIONS
Expressions of AR and ER-beta were stronger in glands of the endometrium of postmenopausal women after treatment with testosterone added to estrogen than after estrogen alone. In contrast, expressions of ER-alpha and progesterone receptors were up-regulated in the endometrium with estrogen-alone treatment, whereas these expressions were less increased in glands after combined treatment. These data indicate that testosterone is involved in the regulation of sex hormone receptor expression in the postmenopausal endometrium and may therefore influence endometrial proliferation and differentiation.
目的
我们的目的是研究与单独使用雌激素相比，添加睾酮的雌激素对绝经后妇女子宫内膜腺体和基质中性激素受体表达及分布的影响。
设计
在一所大学医院的妇女健康研究室进行了一项开放、随机的平行组比较临床研究。31名绝经后妇女接受口服戊酸雌二醇（每日2毫克）或戊酸雌二醇联合十一酸睾酮（每2天40毫克）治疗3个月。在治疗前和治疗结束时获取子宫内膜活检样本，通过免疫组织化学分析评估雌激素受体（ER）-α、ER-β、孕激素受体亚型A和B以及雄激素受体（AR）的表达。
结果
在基线时，ER-α和孕激素受体在腺体中的表达强于基质，而AR的免疫染色在基质中强于腺体。治疗后，两种治疗方法均使腺体和基质中的ER-α和孕激素受体表达上调，但联合治疗使腺体中的上调程度较小。联合治疗组腺体中ER-β的表达显著高于单独使用雌激素组。此外，联合治疗后AR免疫染色显著高于单独使用雌激素治疗后。
结论
绝经后妇女在雌激素中添加睾酮治疗后，子宫内膜腺体中AR和ER-β的表达强于单独使用雌激素后。相比之下，单独使用雌激素治疗可使子宫内膜中ER-α和孕激素受体表达上调，而联合治疗后腺体中的这些表达增加较少。这些数据表明睾酮参与绝经后子宫内膜中性激素受体表达的调节，因此可能影响子宫内膜的增殖和分化。
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