• 四川省醫(yī)學(xué)科學(xué)院·四川省人民醫(yī)院（成都，610072）1 泌尿外科，3 小兒外科;;
  • 2 四川省中醫(yī)院老年科;

目的 觀察先天性尿道下裂和單純性陰莖下曲患者陰莖皮膚組織中雄激素受體（androgen receptor，AR）的表達情況，探討其在不同程度尿道下裂和陰莖下曲中的表達特征及規(guī)律。 方法 以2005 年8 月－ 2007 年1 月行矯正術(shù)的25 例先天性尿道下裂和4 例單純性陰莖下曲患者為研究對象，采集陰莖背側(cè)包皮、尿道口腹側(cè)皮膚和尿道板組織。尿道下裂患者年齡1 歲11 個月～ 19 歲，平均3 歲7 個月；陰莖下曲患者年齡3 歲6 個月～ 16 歲，平均7 歲1 個月。以18 例行包皮環(huán)切術(shù)患者的正常背、腹側(cè)包皮作為對照。免疫組織化學(xué)染色觀察并檢測標(biāo)本AR 的表達水平和分布情況，行統(tǒng)計學(xué)分析。 結(jié)果 先天性尿道下裂、單純性陰莖下曲和正常包皮組織中均有AR 表達。正常陰莖背、腹側(cè)包皮AR 表達核陽性細(xì)胞率分別為62.94% ± 5.40%、62.87% ± 5.33%；先天性尿道下裂陰莖背側(cè)包皮、尿道口腹側(cè)皮膚及尿道板組織分別為59.00% ± 3.75%、58.46% ± 4.14%、52.30% ± 3.53%，AR 表達均低于正常背、腹側(cè)包皮（P  lt; 0.05）；且尿道板組織AR 表達顯著低于自身背、腹側(cè)包皮皮膚（P  lt; 0.05），自身背、腹側(cè)包皮皮膚間差異無統(tǒng)計學(xué)意義（P  gt; 0.05）。與正常背、腹側(cè)包皮比較：遠(yuǎn)、中段型尿道下裂陰莖背側(cè)包皮AR 表達差異無統(tǒng)計學(xué)意義（P  gt; 0.05），但尿道板組織AR 表達顯著降低（P  lt; 0.05）；近段型背側(cè)包皮、尿道口腹側(cè)皮膚及尿道板組織AR 表達均降低（P  lt; 0.05）；下曲 lt; 45° 者陰莖背側(cè)包皮、尿道口腹側(cè)皮膚AR 表達差異無統(tǒng)計學(xué)意義（P  gt; 0.05），下曲≥ 45° 者比較差異均有統(tǒng)計學(xué)意義（P  lt; 0.05），兩組尿道板組織AR 表達均降低（P  lt; 0.05）。單純性尿道下曲患者陰莖背側(cè)包皮、尿道口腹側(cè)皮膚及尿道板組織AR 表達核陽性細(xì)胞率分別為59.69% ± 2.73%、55.71% ± 1.67%、51.92% ± 1.87%，與正常包皮組織比較，AR 表達呈減弱趨勢。 結(jié)論 先天性尿道下裂及單純性陰莖下曲陰莖皮膚組織AR 表達低于正常陰莖，尿道板組織AR 缺陷突出。

引用本文： 安宇 ,劉雪輝,唐耘熳,劉競,李俊,羅一釗,邱明星. 先天性尿道下裂和單純性陰莖下曲患者陰莖皮膚組織中雄激素受體表達研究. 中國修復(fù)重建外科雜志, 2012, 26(4): 461-465. doi: 復(fù)制

1. Kalfa N, Philibert P, Sultan C. Is hypospadias a genetic, endocrine or environmental disease, or still an unexplained malformation? Int J Androl, 2009, 32(3): 187-197.
2. Kalfa N, Philibert P, Baskin LS, et al. Hypospadias: interactions between environment and genetics. Mol Cell Endocrinol, 2011, 335(2): 89-95.
3. Vottero A, Minari R, Viani I, et al. Evidence for epigenetic abnormalities of the androgen receptor gene in foreskin from children with hypospadias. J Clin Endocrinol Metab, 2011, 96(12): E1953-1962.
4. Kojima Y, Kohri K, Hayashi Y. Genetic pathway of external genitalia formation and molecular etiology of hypospadias. J Pediatr Urol, 2010, 6(4): 346-354.
5. Yong W, Yang Z, Periyasamy S, et al. Essential role for Co-chaperone Fkbp52 but not Fkbp51 in androgen receptor-mediated signaling and physiology. J Biol Chem, 2007, 282(7): 5026-5036.
6. Beleza-Meireles A, Barbaro M, Wedell A, et al. Studies of a co-chaperone of the androgen receptor, FKBP52, as candidate for hypospadias. Reprod Biol Endocrinol, 2007, 5: 8.
7. 李春, 謝家倫, 盧漢平. 先天性尿道下裂陰莖皮膚細(xì)胞雌雄激素受體表達及胞核內(nèi)的聚集. 中華小兒外科雜志, 1998, 19(5): 275-278.
8. Bentvelsen FM, Brinkmann AO, van der Linden JE, et al. Decreased immunoreactive androgen receptor levels are not the cause of isolated hypospadias. Br J Urol, 1995, 76(3): 384-388.
9. 蔣學(xué)武, 陳紹基, 王光義, 等. 先天性尿道下裂陰莖雄激素受體的研究. 中華小兒外科雜志, 1995, 16(3): 141-142.
10. Celayir S, Eliçevik M, Tireli G, et al. Expression of estrogen and androgen receptors in children with hypospadias: preliminary report. Arch Androl, 2007, 53(2): 83-85.
11. 唐耘熳, 黃進, 陳紹基, 等. 小兒先天性無尿道下裂陰莖下曲畸形的解剖特點及診治. 中國修復(fù)重建外科雜志, 2006, 20(3): 217-219.
12. Baskin LS. Hypospadias and urethral development. J Urol, 2000, 163(3): 951-956.
13. Kraft KH, Shukla AR, Canning DA. Hypospadias. Urol Clin North Am, 2010, 37(2): 167-181.
14. Roberts J. Hypospadias surgery past, present and future. Curr Opin Urol, 2010, 20(6): 483-489.
15. Barbagli G, Perovic S, Djinovic R, et al. Retrospective descriptive analysis of 1,176 patients with failed hypospadias repair. J Urol, 2010, 183(1): 207-211.
16. Catti M, Demède D, Valmalle AF, et al. Management of severe hypospadias. Indian J Urol, 2008, 24(2): 233-240.
17. Montag S, Palmer LS. Abnormalities of penile curvature: chordee and penile torsion. Scientific World Journal, 2011, 11: 1470-1478.
18. Tang YM, Chen SJ, Huang LG, et al. Chordee without hypospadias: report of 79 Chinese prepubertal cases. J Androl, 2007, 28(4): 630-633.
19. Bhat A. Extended urethral mobilization in incised plate urethroplasty for severe hypospadias: a variation in technique to improve chordee correction. J Urol, 2007, 178(3 Pt 1): 1031-1035.
20. Snodgrass WT. Management of penile curvature in children. Curr Opin Urol, 2008, 18(4): 431-435.
  1. 1. Kalfa N, Philibert P, Sultan C. Is hypospadias a genetic, endocrine or environmental disease, or still an unexplained malformation? Int J Androl, 2009, 32(3): 187-197.
  2. 2. Kalfa N, Philibert P, Baskin LS, et al. Hypospadias: interactions between environment and genetics. Mol Cell Endocrinol, 2011, 335(2): 89-95.
  3. 3. Vottero A, Minari R, Viani I, et al. Evidence for epigenetic abnormalities of the androgen receptor gene in foreskin from children with hypospadias. J Clin Endocrinol Metab, 2011, 96(12): E1953-1962.
  4. 4. Kojima Y, Kohri K, Hayashi Y. Genetic pathway of external genitalia formation and molecular etiology of hypospadias. J Pediatr Urol, 2010, 6(4): 346-354.
  5. 5. Yong W, Yang Z, Periyasamy S, et al. Essential role for Co-chaperone Fkbp52 but not Fkbp51 in androgen receptor-mediated signaling and physiology. J Biol Chem, 2007, 282(7): 5026-5036.
  6. 6. Beleza-Meireles A, Barbaro M, Wedell A, et al. Studies of a co-chaperone of the androgen receptor, FKBP52, as candidate for hypospadias. Reprod Biol Endocrinol, 2007, 5: 8.
  7. 7. 李春, 謝家倫, 盧漢平. 先天性尿道下裂陰莖皮膚細(xì)胞雌雄激素受體表達及胞核內(nèi)的聚集. 中華小兒外科雜志, 1998, 19(5): 275-278.
  8. 8. Bentvelsen FM, Brinkmann AO, van der Linden JE, et al. Decreased immunoreactive androgen receptor levels are not the cause of isolated hypospadias. Br J Urol, 1995, 76(3): 384-388.
  9. 9. 蔣學(xué)武, 陳紹基, 王光義, 等. 先天性尿道下裂陰莖雄激素受體的研究. 中華小兒外科雜志, 1995, 16(3): 141-142.
  10. 10. Celayir S, Eliçevik M, Tireli G, et al. Expression of estrogen and androgen receptors in children with hypospadias: preliminary report. Arch Androl, 2007, 53(2): 83-85.
  11. 11. 唐耘熳, 黃進, 陳紹基, 等. 小兒先天性無尿道下裂陰莖下曲畸形的解剖特點及診治. 中國修復(fù)重建外科雜志, 2006, 20(3): 217-219.
  12. 12. Baskin LS. Hypospadias and urethral development. J Urol, 2000, 163(3): 951-956.
  13. 13. Kraft KH, Shukla AR, Canning DA. Hypospadias. Urol Clin North Am, 2010, 37(2): 167-181.
  14. 14. Roberts J. Hypospadias surgery past, present and future. Curr Opin Urol, 2010, 20(6): 483-489.
  15. 15. Barbagli G, Perovic S, Djinovic R, et al. Retrospective descriptive analysis of 1,176 patients with failed hypospadias repair. J Urol, 2010, 183(1): 207-211.
  16. 16. Catti M, Demède D, Valmalle AF, et al. Management of severe hypospadias. Indian J Urol, 2008, 24(2): 233-240.
  17. 17. Montag S, Palmer LS. Abnormalities of penile curvature: chordee and penile torsion. Scientific World Journal, 2011, 11: 1470-1478.
  18. 18. Tang YM, Chen SJ, Huang LG, et al. Chordee without hypospadias: report of 79 Chinese prepubertal cases. J Androl, 2007, 28(4): 630-633.
  19. 19. Bhat A. Extended urethral mobilization in incised plate urethroplasty for severe hypospadias: a variation in technique to improve chordee correction. J Urol, 2007, 178(3 Pt 1): 1031-1035.
  20. 20. Snodgrass WT. Management of penile curvature in children. Curr Opin Urol, 2008, 18(4): 431-435.