Johns M E, MacLeod R M, Cantrell R W
Laryngoscope. 1980 Apr;90(4):628-34. doi: 10.1288/00005537-198004000-00009.
Nasopharyngeal angiofibromas, which occur exclusively in pubescent males, are frequently treated with estrogens in an effort to decrease their size and vascularity. It has been presumed by some that estrogen has a direct effect on the tumor itself. Others have felt that hormone acts by affecting the pituitary-gonadal axis. In this study, six male patients with nasopharyngeal angiofibromas had their tumors analyzed for estrogen receptors and none were found. Despite this fact, two of these patients treated with estrogens showed clinical evidence of a decrease in tumor size and vascularity. This response occurring in the absence of estrogen receptors suggests that the action of estrogen on nasopharyngeal angiofibromas is indirect. Alternatively these tumors may be testosterone dependent and the administration of estrogen suppresses the normal male testosterone levels, with a resultant reduction in tumor size and vascularity. Twenty-four patients with nasopharyngeal angiofibroma have been treated at the University of Virginia in the past 22 years. The average blood loss at operation was 1900 cc. When estrogens were administered preoperatively in 3 patients, the average blood loss was 1135 cc. Those patients who received no estrogens averaged 2000 cc blood loss. These figures do not reflect the size or extent of the disease, both of which greatly influence blood loss.
鼻咽血管纤维瘤仅发生于青春期男性，为减小其大小和血管分布，常采用雌激素进行治疗。一些人推测雌激素对肿瘤本身有直接作用。另一些人则认为激素通过影响垂体 - 性腺轴发挥作用。在本研究中，对6例患有鼻咽血管纤维瘤的男性患者的肿瘤进行了雌激素受体分析，结果均未发现雌激素受体。尽管如此，其中2例接受雌激素治疗的患者出现了肿瘤大小和血管分布减小的临床证据。在没有雌激素受体的情况下出现这种反应表明，雌激素对鼻咽血管纤维瘤的作用是间接的。或者，这些肿瘤可能依赖睾酮，而给予雌激素会抑制正常男性的睾酮水平，从而导致肿瘤大小和血管分布减小。在过去22年中，弗吉尼亚大学共治疗了24例鼻咽血管纤维瘤患者。手术中的平均失血量为1900毫升。3例术前使用雌激素的患者，平均失血量为1135毫升。未接受雌激素治疗的患者平均失血量为2000毫升。这些数字并未反映疾病的大小或范围，而这两者都会极大地影响失血量。
