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[他莫昔芬治疗子宫内膜癌的组织病理学变化]

[Histopathological changes in endometrial cancer treated with tamoxifen].

作者信息

Lin H H, Ueda K, Kato J

出版信息

Gan To Kagaku Ryoho. 1986 Apr;13(4 Pt 1):1038-43.

PMID:3963849
Abstract

Eight cases of endometrial adenocarcinoma, including 7 well differentiated cases (stage Ia three, stage Ib three, stage II one) and I poorly differentiated case (stage IVb), were treated with Tamoxifen (20 mg/day) for 7-14 days. The average age of these patients was 59.1 +/- 10.9 years old and they were all postmenopausal for between 6 months and 30 years. The endometrial tissue was biopsied before Tamoxifen administration and half of it was investigated for progestin receptor (PR) and estrogen receptor (ER) while the remainder was used for histopathological examination. After surgical treatment, some tissue fragments of the endometrium were taken for investigation of PR and ER. The effect of Tamoxifen was then studied for the amount of PR, ER and histopathology. The result was that the amount of PR was increased in well differentiated cases whereas it was unchanged in poorly differentiated ones, and the amount of ER was decreased in all cases. Meanwhile, obvious histopathological changes were noted as follows decrease of glandular epithelial stratification, increased secretory activity, increased epithelial cell size with columnar cell type, increase of transparent, vacuolated cytoplasm, increase of nuclear size with variable shape and prominent nucleoli with marginal aggregation of chromatin. However, no stromal change was noted. Furthermore, the greater the increase in the amount of PR, the more conspicuous histopathological change was noted. It was concluded that Tamoxifen could produce both functional (PR, ER) and morphological (histopathology) changes in endometrial cancers.

摘要

8例子宫内膜腺癌患者,其中7例高分化(Ia期3例,Ib期3例,II期1例),1例低分化(IVb期),接受他莫昔芬(20mg/天)治疗7 - 14天。这些患者的平均年龄为59.1±10.9岁,均为绝经后6个月至30年。在给予他莫昔芬之前取子宫内膜组织活检,一半用于检测孕激素受体(PR)和雌激素受体(ER),其余用于组织病理学检查。手术治疗后,取一些子宫内膜组织碎片检测PR和ER。然后研究他莫昔芬对PR、ER含量及组织病理学的影响。结果显示,高分化病例中PR含量增加,而低分化病例中PR含量无变化,所有病例中ER含量均降低。同时,观察到明显的组织病理学变化如下:腺上皮分层减少、分泌活性增加、柱状细胞类型的上皮细胞大小增加、透明空泡状细胞质增加、核大小增加且形状可变、核仁突出且染色质边缘聚集。然而,未观察到间质变化。此外,PR含量增加越多,组织病理学变化越明显。结论是他莫昔芬可使子宫内膜癌产生功能性(PR、ER)和形态学(组织病理学)变化。

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