Expression Of Leptin, Ob-R, ER, PR, VEGF And The Clinicopathologic Analysis Of Celluer Uterine Leimyoma

Objective: Uterine leimyoma (LM) is the most frequent benign tumor of uterus,often found in child-bearing period woman. The potentiality of malignant transformation of LM is usually infrequent. Some researches approved that the development and growth of LM cells were concerned with the disproportion of estrogen, progestogen and cytogebetic abnormality. That celluar uterine leiomyoma of (CUL) was a kind of special category of uterine leimyoma was proposed in the past few years, while pathogenesis and biological behaviour of CUL are still indefinite. Some specialists hold that CUL belonged to the boundary tumor. Therefore, the aim of present study was trying to prove the relationship between patho-characteristics of CUL and clinical biological behaviour.PartⅠExpression of Leptin, ob-R, ER, PR, VEGF in Celluer Uterine LeimyomaObjective: To explore the pathogenesis of CUL in endocrine and vascular aspects and expect to find some new views about the etiopathogenisis and pathogenesis of CUL.Methods: All the patients were chosen from the Second Hospital of Hebei Medical University during November 2006 to August 2007. 30 patients with LM were recruited as control group, while 30 patients with CUL were recruited as study group. All the slides were reviewed and diagnosis was checked again by two senior pathologists. Enrolled women who suffered acute or chronic inflammation and severe diseases including function failure of heart, liver, kidney were excluded from the present study. In the same time, they didn't use hormones preparation within 3 months. There were no significant differences between above two groups of their age and body mass index (BMI) (P>0.05). The statistical software SASv6.12 was used to analyze acquired data. The data were contrasted withχ2 test, Fisher Exact test or rank sum test. It is considered there is significant if P values less than 0.05.Results:1 General informationThere were no significant differences between two groups of their age and BMI.2 The expression of leptin, obese receptor (ob-R), estrogen receptor (ER), progesterone receptor (PR), vascular endothelial growth factor (VEGF) in LM and CUL2.1 The expression of leptin in the LM and CUL2.1.1 There were significantly different between the expression of leptin in LM and those in CUL (P<0.05). There were 24 cases of positive expression in 30 cases of LM and 29 cases of positive expression in 30 cases of CUL.2.1.2 There were significantly different between expressive intensity of leptin in LM and those in CUL (P<0.05). The leptin expressed in 30 cases of LM, there were 13 cases of equivocally positive expression, 7 cases of positive expression and 4 cases of stronger positive expression. The leptin was expressed in 30 cases of CUL, there were 8 cases of equivocally positive expression, 10 cases of positive expression and 11 cases of stronger positive expression. The expression of leptin in CUL was higher than that in LM.2.2 The expression of ob-R in the LM and CUL2.2.1 There were no significant difference between the expression of ob-R in LM and those in CUL (P>0.05). There were 25 cases of positive expression in 30 cases of LM, 26 cases of positive expression in 30 cases of CUL.2.2.2 There were no significant difference between expressive intensity of ob-R in LM and those in CUL (P>0.05). The ob-R was expressed in 30 cases of LM, there were 13 cases of equivocally positive expression, 7 cases of positive expression and 5 cases of stronger positive expression in LM. The ob-R was expressed in 30 cases of CUL, there were 10 cases of equivocally positive expression, 6 cases of positive expression and 10 cases of stronger positive expression.2.3 The expression of VEGF in LM and CUL2.3.1 There were significantly different between the expression of VEGF in LM and those in CUL (P<0.05). There were 22 cases of positive expression in 30 cases of LM, 28 cases of positive expression in 30 cases of CUL. 2.3.2 There were significantly different between expressive intensity of VEGF in LM and those in CUL (P<0.05). The VEGF was expressed in 30 cases of LM, there were 13 cases of equivocally positive expression, 7 cases of positive expression and 5 cases of stronger positive expression. The VEGF was expressed in 30 cases of CUL, there were 10 cases of equivocally positive expression, 6 cases of positive expression and 10 cases of stronger positive expression. The expression of VEGF in CUL was higher than that in LM.2.4 The expression of ER in LM and CUL2.4.1 There were no significant difference between the expression of ER in LM and those in CUL (P>0.05). Among which there were 29 cases of positive expression in 30 cases of LM, 28 cases of positive expression in 30 cases of CUL.2.4.2 There were no significant difference between expressive intensity of ER in LM and those in CUL (P>0.05). The ER was expressed in 30 cases of LM, there were 7 cases of equivocally positive expression, 8 cases of positive expression and 13 cases of stronger positive expression. The ER was expressed in 30 cases of CUL, there were 5 cases of equivocally positive expression, 8 cases of positive expression and 15 cases of stronger positive expression.2.5 The expression of PR in LM and CUL2.5.1 There were no significant difference between the expression of PR in LM and those in CUL (P>0.05). There were 28 cases of positive expression in 30 cases of LM, 29 cases of positive expression in 30 cases of CUL.2.5.2 There were no significant difference between expressive intensity of PR in LM and those in CUL (P>0.05). The PR was expressed in 30 cases of LM, there were 8 cases of equivocally positive expression, 9 cases of positive expression and 11 cases of stronger positive expression. The PR was expressed in 30 cases of CUL, there were 7 cases of equivocally positive expression, 11 cases of positive expression and 11 cases of stronger positive expression.Conclusions:These results indicated that the increase in the expression of leptin and VEGF may be related to the development and pathogenesis of CUL, the two indexes may promote the growth of CUL.PartⅡThe Clinicopathologic Parameters Analysis of CULObjective: To analyze the clinic-histopathological characteristics of cellular uterine leiomyoma (CUL) for guiding the diagnosis and treatment of CUL.Methods: All the patients were chosen from the Second Hospital of Hebei Medical University during January 2000 to January 2007. The information of 78 patients with CUL were collected, their clinicopathologic features, B-ultrasound founding, methods for operation were analyzed. Besides, all postoperative patients were followed up from 6 to 60 months in order to observe their recurrence. Results: Menstrual changes were main symptoms. Smooth muscle cells were plentiful, but karykinesis were seldom, it is less than 5 per 10 highpower field. Most lump of uterus with CUL patients showed equal or low level echo areas undering B-ultrasound examination. The recurrence rate of CUL was 22.8% (8/35)in these patients accepted myomectomy.Conclusions: The clinical features of CUL were similar to ordinary uterine leiomyoma patients. We suggest that CUL patients who suffered recurrence of myoma should accept the hysterectomy.