Department of Obstetrics & Gynecology, Jinan Military General Hospital, #25 Shifan Road, Jinan 250031, China.
World J Surg Oncol. 2012 Jun 1;10:100. doi: 10.1186/1477-7819-10-100.
The purpose of the research is to study the histopathology and expression of survivin, estrogen and progesterone receptors (ER/PR) in the endometrium of patients with dysfunctional uterine bleeding (DUB) treated with radiofrequency endometrial ablation (REA).
A total of 98 DUB patients were enrolled in this case-control study. Among them, 66 underwent REA treatment and 32 optioned for hormone therapy as the control group. Immunohistochemical analysis for survivin, ER and PR expression was carried out on endometrial tissue samples collected before and 6 to 7 months after treatment for both groups.
Both hormone and REA treatment ameliorated menstrual bleeding of DUB patients, with the latter showing a significantly higher effective rate. Endometrial surface tissue was replaced by fibrosis tissue in the REA treatment group. REA treatment also significantly reduced the expression of survivin, ER, and PR. Endometrial surface tissues collected from the hormone-treated control group neither showed any apparent morphological alteration nor in the expression of those receptors.
REA treatment changed endometrial surface tissue type from gland rich to gland poor, and significantly decreased the expression of survivin, ER, and PR. This may be an important contributing mechanism for the long-term curative effect and prevention of DUB recurrence.
本研究旨在探讨射频子宫内膜消融术（REA）治疗功能失调性子宫出血（DUB）患者的子宫内膜组织中生存素、雌激素和孕激素受体（ER/PR）的组织病理学表现和表达。
本病例对照研究共纳入 98 例 DUB 患者。其中 66 例行 REA 治疗，32 例选择激素治疗作为对照组。对两组患者治疗前后 6-7 个月的子宫内膜组织标本进行生存素、ER 和 PR 表达的免疫组织化学分析。
激素和 REA 治疗均可改善 DUB 患者的月经过多症状，后者的有效率明显更高。REA 治疗组的子宫内膜表面组织被纤维组织取代。REA 治疗还显著降低了生存素、ER 和 PR 的表达。激素治疗对照组的子宫内膜表面组织既没有明显的形态改变，也没有这些受体的表达。
REA 治疗使子宫内膜表面组织类型从富含腺体转变为腺体减少，并显著降低了生存素、ER 和 PR 的表达。这可能是 REA 治疗长期疗效和预防 DUB 复发的重要机制。
