本文選題：子宮內(nèi)膜增生癥　切入點(diǎn)：ARID1A基因　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究AT豐富結(jié)構(gòu)結(jié)構(gòu)域1A(AT rich interaction domain 1A,ARID1A)ARID1A基因、雄激素受體(AR)在子宮內(nèi)膜增生癥不同病變中的表達(dá)情況,同時(shí)分析其與雌激素受體(ER)、孕激素受體(PR)的相關(guān)性,探討ARID1A、AR在子宮內(nèi)膜增生癥發(fā)生發(fā)展中的作用,旨在了解子宮內(nèi)膜增生癥的病因和發(fā)病機(jī)制,探索子宮內(nèi)膜增生癥防治的新的思路,為預(yù)防和降低子宮內(nèi)膜癌的發(fā)生奠定理論依據(jù)。方法:選取2013年1月至2016年6月山西省婦幼保健院病理科132例子宮內(nèi)膜增生癥組織標(biāo)本(包括單純型增生40例,復(fù)雜型增生40例,不典型增生52例),選取同期增殖期子宮內(nèi)膜組織28例作為對照組,所有標(biāo)本均經(jīng)過病理學(xué)證實(shí),3個(gè)月內(nèi)未接受激素治療。懫用免疫組織化學(xué)方法(streptavidin peroxidase-biotin,SP)檢測ARID1A、ER、PR、AR在增殖期內(nèi)膜、子宮內(nèi)膜增生各級別病變組織中的表達(dá)。應(yīng)用SPSS21.0進(jìn)行統(tǒng)計(jì)分析,ARID1A、ER、PR、AR蛋白表達(dá)率運(yùn)用x2檢驗(yàn);ARID1A、AR與ER、PR表達(dá)相關(guān)性用Spearman相關(guān)分析。結(jié)果:1、子宮內(nèi)膜組織中廣泛存在ER、PR、AR的表達(dá),ER、PR在增殖期子宮內(nèi)膜、單純型增生、復(fù)雜型增生、不典型增生各組間差異無統(tǒng)計(jì)學(xué)意義(P=0.143,P=0.496);AR在不典型增生組陽性表達(dá)率最低,與其余各組間比較,差異具有統(tǒng)計(jì)學(xué)意義(P=0.018),增殖期內(nèi)膜組,單純型增生組、復(fù)雜型增生組,各組間比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)2、ARID1A基因在子宮內(nèi)膜腺上皮和間質(zhì)細(xì)胞核中廣泛表達(dá),隨著病變的發(fā)展,ARID1A基因表達(dá)的缺失率逐漸增加,在不典型子宮內(nèi)膜組中,ARID1A表達(dá)缺失率為19.2%,與其余組間比較,差異有統(tǒng)計(jì)學(xué)意義(x2=11.58,P=0.004),(P0.05)3、子宮內(nèi)膜增生組織中ARID1A與ER、PR、AR之間無明顯的相關(guān)性(rs=-0.066,P=0.455;rs=0.001,P=0.987;rs=0.114,P=0.191);AR與ER、PR的表達(dá)呈正相關(guān)性(rs=0.176,P=0.043;rs=0.195,P=0.025)。結(jié)論:1、ARID1A基因突變和表達(dá)缺失是子宮內(nèi)膜增生惡變過程中的一個(gè)早期事件。2、雄激素及其受體可能參與了子宮內(nèi)膜增生癥的發(fā)生發(fā)展。3、對于AR陽性的部分子宮內(nèi)膜增生患者,聯(lián)合降低雄激素治療,有可能成為子宮內(nèi)膜增生癥治療的一個(gè)新的策略。
[Abstract]:Objective: to study the expression of 1A(AT rich interaction domain 1AnARID1A gene and androgen receptor ARID1A in different lesions of endometrial hyperplasia, and to analyze the relationship between AT rich domain and estrogen receptor ERA and progesterone receptor.To explore the role of ARID1 Agnar in the occurrence and development of endometrial hyperplasia, to understand the etiology and pathogenesis of endometriosis, and to explore a new idea for the prevention and treatment of endometriosis.In order to prevent and reduce the occurrence of endometrial carcinoma lay a theoretical basis.Methods: from January 2013 to June 2016, 132 specimens of endometrial hyperplasia (including 40 cases of simple hyperplasia and 40 cases of complex hyperplasia) were collected from Department of Pathology of Shanxi Maternal and Child Health Hospital.52 cases of atypical hyperplasia and 28 cases of proliferative endometrium were selected as control group. All the specimens were confirmed by pathology and did not receive hormone therapy within 3 months.The expression of AR in proliferative endometrium and endometrial hyperplasia was detected by immunohistochemical method (streptavidin peroxidase-biotin SPN).SPSS21.0 was used to analyze the expression rate of AR protein in ARID1 Agna. The correlation between AR and PR was analyzed by Spearman correlation analysis with x2 test.Results there was no significant difference in the expression of ERP PRAR in endometrial tissues in proliferative endometrium, simple hyperplasia, complex hyperplasia and atypical hyperplasia. The positive rate of ERP was the lowest in atypical hyperplasia group.Compared with the other groups, the difference was statistically significant (P 0.018), the proliferative endometrium group, simple hyperplasia group, complex hyperplasia group, and there was no significant difference in the expression of ARID1A gene in endometrial glandular epithelium and interstitial nucleus, and there was no significant difference in the expression of ARID1A gene in endometrial glandular epithelium and interstitial nucleus.With the development of pathological changes, the deletion rate of ARID1A gene increased gradually, and the deletion rate of ARID1A gene in atypical endometrium was 19.2%, compared with other groups.Conclusion the mutation and deletion of ARID1A gene is an early event in the process of endometrial hyperplasia and malignant transformation. Androgen and its receptor may be involved in the occurrence and development of endometrial hyperplasia .3. for some patients with AR positive endometrial hyperplasia, androgen and its receptor may be involved in the occurrence and development of endometrial hyperplasia.Combined androgen reduction therapy may be a new strategy for the treatment of endometrial hyperplasia.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.74

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