Kaya Ahmet H, Ulus Aykan, Bayri Yasar, Topal Arif, Gun Seda, Kandemir Bedri, Dagcinar Adnan, Senel Alparslan, Iyigun Omer
Department of Neurosurgery, Faculty of Medicine, Ondokuz Mayis University, Kurupelit, Samsun, Turkey.
Surg Neurol. 2009 Sep;72(3):263-5; discussion 265. doi: 10.1016/j.surneu.2008.09.014. Epub 2009 Jan 14.
Literature consistently mentions that pregnancy and hormonal therapy probably increase the bleeding rate and seizure expression of cerebral cavernomas. Either increased hormonal activity or embryogenesis related abundant expression of some growth factors such as VEGF, bFGF, and placental growth factor during pregnancy were proposed to initiate angiogenic process and vascular proliferation in cavernomas, thereby increasing their bleeding rate and seizure expression.
To reveal whether estrogen and/or progesterone have direct effect on cerebral cavernomas, their receptor expressions were studied immunohistochemically in recently excised 12 cerebral cavernomas.
Study showed no expression of either estrogen or progesterone receptors in cerebral cavernomas even the staining worked well in positive control tissues of infiltrative ductal carcinoma.
Aggressive behavior of cerebral cavernomas during pregnancy is a commonly proven observation and attributed to some hormonal effects. However, this effect seems not related to effect of estrogen or progesterone on cavernoma tissue via receptor binding.
文献一直提及怀孕和激素治疗可能会增加脑海绵状血管瘤的出血率和癫痫发作表现。有人提出，怀孕期间激素活性增加或某些生长因子（如血管内皮生长因子、碱性成纤维细胞生长因子和胎盘生长因子）与胚胎发生相关的大量表达会引发海绵状血管瘤的血管生成过程和血管增殖，从而增加其出血率和癫痫发作表现。
为了揭示雌激素和/或孕激素是否对脑海绵状血管瘤有直接影响，对最近切除的12例脑海绵状血管瘤进行免疫组织化学研究，检测其受体表达情况。
研究表明，脑海绵状血管瘤中雌激素和孕激素受体均无表达，即使在浸润性导管癌的阳性对照组织中染色效果良好。
怀孕期间脑海绵状血管瘤的侵袭性行为是一个普遍得到证实的观察结果，且归因于某些激素作用。然而，这种作用似乎与雌激素或孕激素通过受体结合对海绵状血管瘤组织的作用无关。
