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[乳腺病与乳腺癌:是否存在典型的激素谱?]

[Mastopathy and breast cancer: is there a typical hormone profile?].

作者信息

Völker W, Leipert K P, Gehrlings H, Stauch G, von zur Mühlen A, Schneider J

出版信息

Geburtshilfe Frauenheilkd. 1986 May;46(5):284-9. doi: 10.1055/s-2008-1035916.

Abstract

Carcinoma of the breast and mastopathy are statistically correlated with the functioning of the gonads. The authors studied whether in 58 women with carcinoma of the breast and in 36 patients with mastopathy any change was seen in the secretory pattern of gonadal steroids and whether there were any latent changes in the secretion of prolactin and TSH. A group of 43 women with benign gynaecological diseases served as controls. Before making the diagnosis via immediate section for microscopic examination we determined the basal values of prolactin, LH, FSH, TSH and the oestrogen fractions E1, E2, E3, total oestrogens and progesterone. In addition, we measured the increase in prolactin and TSH after stimulation with metoclopramide. Postoperatively this was followed by measuring the basal values of prolactin and TSH and their secretory performance in respect of TRH. All histological diagnoses were made by an experienced pathologist. Examinations were performed under strictly standardised conditions, taking into account stress, circadian variation and the nutritional status. The following group-specific significant results were obtained (p less than 0.05-0.01): Mastopathy: high serum values of all oestrogen fractions and of total oestrogens, high PRL release through MTC stimulation, prolactin secretory effect after MTC in accordance with the degree of severity of epithelial proliferation, early onset of menopause. Carcinoma of the breast: Low PRL and TSH release on MTC stimulation, low progesterone concentrations during the second cycle phase, relatively high serum concentrations of oestradiol during the first cycle phase, PRL basal values increased postoperatively, compared with preoperative values. The results led to the following conclusions: In mastopathy patients there is a connection between high oestrogen concentrations and consecutively high prolactin release. The morphological substrate is represented by an enhanced proliferation of epithelium. In patients with cancer of the breast reduced progesterone concentrations during the second half of the cycle lead us to suspect an increased incidence of luteal insufficiency; in addition, it appears that the daily prolactin secretion rate in this group is on a reduced level.

摘要

乳腺癌和乳腺病在统计学上与性腺功能相关。作者研究了58例乳腺癌女性患者和36例乳腺病患者的性腺类固醇分泌模式是否有变化,以及催乳素和促甲状腺激素分泌是否存在潜在变化。一组43例患有良性妇科疾病的女性作为对照。在通过即时切片进行显微镜检查做出诊断之前,我们测定了催乳素、促黄体生成素、促卵泡生成素、促甲状腺激素以及雌激素组分E1、E2、E3、总雌激素和孕酮的基础值。此外,我们还测量了甲氧氯普胺刺激后催乳素和促甲状腺激素的升高情况。术后,接着测定催乳素和促甲状腺激素的基础值及其对促甲状腺激素释放激素的分泌表现。所有组织学诊断均由经验丰富的病理学家做出。检查在严格标准化的条件下进行,同时考虑到压力、昼夜变化和营养状况。获得了以下组特异性显著结果(p小于0.05 - 0.01):乳腺病:所有雌激素组分和总雌激素的血清值较高,甲氧氯普胺刺激后催乳素释放较高,甲氧氯普胺刺激后催乳素分泌效应与上皮增殖程度相符,绝经提前。乳腺癌:甲氧氯普胺刺激后催乳素和促甲状腺激素释放较低,第二个周期阶段孕酮浓度较低,第一个周期阶段雌二醇血清浓度相对较高,术后催乳素基础值较术前升高。结果得出以下结论:在乳腺病患者中,高雌激素浓度与随后的高催乳素释放之间存在联系。形态学基础表现为上皮细胞增殖增强。在乳腺癌患者中,周期后半期孕酮浓度降低使我们怀疑黄体功能不全的发生率增加;此外,该组患者每日催乳素分泌率似乎处于较低水平。

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