| Uterine leiomyoma are the most common benign tumor in femal genital tract.Steroids hormone are promoters of leiomyoma growth. Traditionally, the majority of them regress after menopause, but some of them have no reduction in tumor size, and even cause symptoms. Recently, investigators have suggested that some peptide growth factors and their receptors maybe important in regulation of leiomyoma growth. The aims of this study were to investigate clinico-pathological characteristics of postmenopausal patients with leiomyoma and the expression of IGF-I, IGF-IR, TGF-β3, and FN in premenopausal and postmenopausal leiomyoma. Part I A Study on Clinico-Pathological Characteristics in Postmenopausal Patients with Symptomatic LeiomyomaIn this study, clinico-pathological characteristics of 98 cases were investigated, including 38 postmenopausal patients with symptomatic leiomyoma from 1992 to2001 in the general hospital and 40 cases from 2000 to 2002 in the central hospitalof gynecology and obstetrics (group A), and 20 postmenopausal patients with regressive leiomyoma from 1997 to 2002 in the general hospital (group B). All patients had no history of hormone replacement treatment within 3 months, and menopaused at least one year earlier. The results as follow:1. The percentage of postmenopausal patients with symptomatic leiomyoma was 2.86% of all the inpatients with leiomyoma during the same time in the generalhospital.2. Mean age at time of diagnosis was 56.79 years in group A. Mean duration of postmenopause of group A was 6.34 years.3. No differences were shown in mean age of menarche, marriage, menopause, and childbearing history.4. The most common symptom of patients in group A was irregular vaginal bleeding.5. No significant difference between group A and B was present either for serum estradiol or progesterone level.6. The misdiagnosis rate was 23.1% in group A. The leiomyoma of group A were misdiagnosed as uterine sarcoma or ovarian tumor commonly.7. 19.2% leiomyoma of group A were cellular leiomyoma, all of group B were common leiomyoma. The change of endometrium in group A and B was similar. No difference was shown in the rate of degeneration in leiomyoma or myometrium between group A and B. The rate of degeneration in leiomyoma was higher than that in the corresponding myometrium in the two groups.8. The majority of group A were treated by hysterectomy with bilateral oophorosalpingectomy.Part II A Study on Expression of IGF-I, IGF-IR, TGF-β3, and FN in LeiomyomaThe expression of IGF-I, IGF-IR, TGF-β3, and FN in 117 cases were examined by immunohistochemical technique, including 57 cases with symptomatic postmenopausal leiomyoma, 20 cases with regressive postmenopausal leiomyoma, 20 cases of proliferative phase, and 20 cases of secretory phase of menstrual cycle, named as group A, B, C , and D respectively. The relationships among expression ofIGF-I, IGF-IR, TGF-β3, and FN were analyzed. The results as follow: 1. The expression of IGF-IThe expression level of IGF-I in leiomyoma and myometrium of group A and B was significantly lower than that of group C and D (P<0.01 for all). The expression level of IGF-I in leiomyoma of group A was significantly higher than group B (P<0.05); the expression level of IGF-I in leiomyoma was significantly higher than that in the corresponding myometrium in group A (P<0.01), but no difference was shown in group B. The expression level of IGF-I appear to decrease in trend after menopause, but autocrined IGF-I in the leiomyoma was beneficial to the growth of symptomatic postmenopausal leiomyoma.2. The expression of IGF-IRThe expression level of IGF-IR appeared a trend to decrease in leiomyoma and myometrium from premenopause to postmenopause. The expression level of IGF-IR in group A was significantly higher than that in group B both in leiomyoma and myometrium (P<0.05). No significant difference between expression level of IGF-IR of group A and C was present, but signi... |
PDF Full Text Request