Study On The Etiology Of Uterine Leiomyoma And The Influencing Factors Of Sacrum Abnormal MR Signals After HIFU

Objective To investigate the expression of inflammatory factors IL-10,TNF-? and TGF-?1 and their correlation in patients with uterine leiomyoma.To investigate the influencing factors of sacrum abnormal MR signal after high-intensity focused ultrasound ablation(HIFU)in uterine fibroids.Methods 30 cases of uterine leiomyoma tissue and normal myometrium tissue were selected in patients with uterine leiomyoma,who underwent hysterectomy or myomectomy after MR scan in genecology department of the first affiliated hospital of Chongqing Medical University.The central part of excised leiomyoma and adjacent normal myometrium tissue far away from the tumor were enrolled in the uterine leiomyoma group and the myometrium group.The expression of IL-10 and TNF-? in uterine leiomyoma and myometrium were detected by RT-PCR method.The correlations among IL-10,TNF-?,TGF-?1,ER? and PR were explored.The pelvic MRI and clinical data of 133 patients with uterine fibroids who underwent HIFU treatment were analyzed.Characteristics ofuterine fibroids and parameters of HIFU were observed.These variables were used to assess respectively their correlation with sacral abnormal MRsignal by using univariate and multivariate analyses.Results The expression of IL-10 was down-regulated in uterine leiomyoma that of uterine myometrium,while the expression of TNF-?,TGF-?1,ER? and PR in uterine fibroids was significantly higher than that of uterine myometrium,and the difference was statistically significant(P<0.05).IL-10 showed significant positive correlation with ER?(P<0.05),while IL-10 had no correlation with PR,TGF-?1 and TNF-?(P>0.05).TNF-? showed positive correlations with ER?,PR and TGF-?1(P<0.05).TGF-?1 also showed positive correlations with ER? and PR(P<0.05).36(27.1%)patients were observed sacrum abnormal MR signal.In the univariate analysis,the distance from fibroid to sacrum,treatment energy and irradiation time manifested significant correlations with sacrum abnormal MR signal(p<0.05).In multivariate logistic regression,the distance from fibroid to sacrum showed significant statistical difference(P=0.003).The OR was 0.918,95% CI was 0.868~0.971.Conclusions The altered levels of IL-10 and TNF-? expression in uterine leiomyoma and synergistic effects with ER?,PR and TGF-?1suggest that multiple factors are involved together in the occurrence of uterine fibroids.The distance from fibroid to sacrum,HIFU irradiation time and treatment energy manifested significant correlations with sacrumabnormal MR signal.Multivariate logistic regression showed that the distance from fibroid to sacrum was a protective factor.