The Expression And Significance Of Estrogen Receptor、Progesterone Receptor And Survivin In High Intensity Focused Ultrasound Treatment Before And After Nonneoplasia Epithelial Disorders Of Skin And Mucosa Of Vulva

Objective1. Study on high intensity focused ultrasound in the treatment efficacy ofnonneoplasia epithelial disorders of skin and mucosa of vulva.2. Study on expression, biological behavior and clinical significance of theestrogen receptor, progesterone receptor and Survivin of high intensity focusedultrasound in treatment of nonneoplasia epithelial disorders of skin and mucosaof vulva before and after,3. To explore the possible mechanism of focused ultrasound therapy fornonneoplasia epithelial disorders of skin and mucosa of vulva.Method1. Collection of86cases with nonneoplasia epithelial disorders of skin andmucosa of vulva, in the Jinan Military General Hospital in January2009toSeptember2011, confirmed by department of pathology. Elimination standard:pregnant and lactating women， the menstrual period of women, no control thecondition in patients with diabetes mellitus，patients with severe cardiovasculardisease, pulmonary disease, brain diseases, hepatic and renal dysfunction.According to International Society for the Study of Vular Disease andInternational Society of Gyneocological Pathologists to discuss the proposedclassification criteria in1987:44cases of squamous hyperplasia of the vulva,34cases of lichen sclerosus of the vulva,8cases of lichen sclerosus complexedwith squamous hyperplasia of vulva. Course of the patient for0.5to15years, the average（5.33±3.33） years, age15to75years, the average（43.06±14.45）years.2. All the selected cases have been signed patient informed consent, andrandomly30cases selected in the86case， taken normal tissues in the normalvulva skin. Before treatment of focused ultrasound in diseased tissue and arandom sample of30cases of patients with lesions in the surrounding normalskin tissue under the colposcopy,6months after therapy of ultrasound, under thecolposcopy taken same part of the diseased tissue and normal tissue.Using theS-P immunity organization chemical process to examine in each organizationthe estrogen acceptor, the progestogen acceptor and Survivin.3. Criteria of the immunohistochemistry results: ER, PR mainly locate inthe cell nucleus, appears few in the cytoblastema. The cell nucleus has theyellowish brown pellet for positive staining, Survivin positioned mainly in thecytoplasm and the nucleus, occurring Brown granules is positive staining in thecytoplasm and nucleus. Survivin and ER, PR express judgments use fromowitzsemi-quantitative grading: Scored according to the color depth and number ofpositive cells of the cell; Count each film in the high-power field×40times:randomly selected10fields, counting100cells per field of vision, a total of1000cells to determine the positive rate of each of its vision, take the average asthe positive cells percentage. According to following method, scoring:(1) thenumber of positive cells <10%, o point;(2) the number of positive cells in10to25percent,1point;(3) the number of positive cells,26to50percent,2points;(4) number of positive cells51to80%,3points;(5) the number ofpositive cells＞80%, four points. The color depth of positive cells, theintensity of the staining: The basic non-colored o points, light yellow1, yellow2points, brown for3minutes. Both score multiplied by, divided into:0point,negative (-);1-4are divided into weakly positive,(+);5-8divided intopositive,(++);9-12is divided into strong positive,(+++).4. Statistical Methods: Data were analyzed using spss13.0statisticalsoftware, Comparison between the two groups using χ2test of the line×list,Spearman rank correlation analysis information for correlation between twovariables, P <0.05was considered statistically significant. Result1.High intensity focused ultrasound in the treatment of86cases of patientswith nonneoplasia epithelial disorders of skin and mucosa of vulva after6months, the degree of vulvar pruritus in patients improved significantly, skinturned the color red or near-normal, Skin elasticity improves. Ratings beforeand after treatment, post-treatment score was significantly lower than beforetreatment, the difference statistically significant（P＜0.05）.2.High-intensity focused ultrasound in the treatment of nonneoplasiaepithelial disorders of skin and mucosa of vulva, low expression of ER and PRin lesions than in normal tissue, reduce the level of estrogen and progesteronereceptors may be one of the mechanisms for nonneoplasia epithelial disorders ofskin and mucosa of vulva. After ultrasound treatment, the estrogen andprogesterone receptor expression levels increased, indicating high intensityfocused ultrasound therapy can make estrogen and progesterone receptorexpression improve.3.Before the treatment of noneoplasia epithelial disorders of skin andmucosa of vulva used high intensity focused ultrasound, Survivin higherexpression in diseased tissue relative to normal tissue. There are activeproliferation District In pathological change area, high expression of Survivinmay be one of the causes of its incidence.4.To a certain extent, before and after focused ultrasound in the treatmentof ER, PR and Survivin expression, prediction focus the efficacy of ultrasoundtreatment of the disease.