Clinical Characters Of Uterine Leiomyoma Among Women 25 Years And Younger

Objective:To analysis the clinicopathological characteristics and risk factors for recurrence of uterine leiomyoma in young patients aged 25 years and younger after myomectomy.The pedigree study was performed in 2 young patients with multiple myoma with FH gene mutation.Methods:A retrospective analysis was made of 201 patients with uterine leiomyoma who were confirmed by pathology in gynecology department of Peking Union Medical College Hospital from October 1,2012 to June 30,2018.The characteristics of the menarcheage,number of uterine leiomyomas and pathological types were summarized.Using unconditional logistic regression model,134 patients who underwent myomectomy and had follow-up data were analyzed for single and multiple factors of recurrence.FH gene sequencing was performed on family members of 2 patients with FH gene mutation.Results:23.4%of 201 patients had special pathological type,which was significantly higher than that in the whole female population.There were no significant differences in other aspects.134 patients with leiomyoma were followed up for 8 to 73 months,with a median follow-up time of 42.5 months.The recurrence rate was 13.2%.The interval between recurrence and operation was 6 to 66 months,and the median recurrence time was 24 months.The age of amenarche,positive family history and preoperative GnRH-a adjuvant medication in recurrence group was significantly higher than that in non-recurrence group(P<0.05).Multivariate analysis also showed that the age of menarche,family history and preoperative GnRH-a treatment were independent risk factors for recurrence(P<0.05).There were no significant differences in BMI,clinical symptoms,myoma size,number,pathological types and surgical methods(P>0.05).Two FH gene sequencing families,one with FH gene C.1214A>G(p.Leu405Ser)mutation,which has not been recorded in ClinVar database,was a newly discovered mutation.Another Family had two mutations of FH gene C.927G>A(p.Pro309Pro)and C.703C>T(p.His235Tyr).The former should be benign mutation,and the latter might be pathogenic mutation.Nephropathy and dermatomyoma were not found in the two families.Conclusion:The proportion of special pathological types in young patients aged 25 and younger is higher than that in thewholewomen with uterine leiomyoma,suggesting that the risk of recurrence or malignancy may be higher.The age of menarche,family history and preoperative GnRH-a were associated with recurrence after myomectomy.FH mutation may be closely related to young,early onset and multiple uterine leiomyomas,especially those with family aggregation tendency.