Expression Of ER, PR, GnRHR, MVD In Uterine Leiomyoma And The Correlation With MRI

Objective To explore expression of ER, PR, GnRHR, MVD in uterine leiomyoma and the correlation with MRI.Methods 16 cases of ordinary leiomyomas and 14 cases of cellular leiomyomas were chose, which were examined by MRI and verified by pathology. 14 cases of normal myometrium were chose as the control group. All cases were detected by immunohistochemistry methods with monoclonal antibody against ER, PR, GnRHR and CD34.Results 1.MRI: All the leiomyomas showed slight hypointensity or isointensity on T1- weighted images. The signal intensity on T2- weighted images and the patterns of enhancement were statistically different between ordinary leiomyomas and cellular leiomyomas. 2.The expression of ER and PR: There was no statistic difference in the positive expression of ER and PR between ordinary leiomyomas and cellular leiomyomas, but both of them were statistically higher than the normal myometrium. 3.The expression of GnRHR: There was no statistic difference in the positive expression of GnRHR between normal myometrium and ordinary leiomyomas, but both of them were statistically lower than cellular leiomyomas. 4.The expression of MVD: The expression of MVD in normal myometrium, ordinary leiomyomas and cellular leiomyomas were not statistically different. 5.The relationship between expression of ER, PR, GnRHR, MVD and MRI: The positive correlation was found between the expression of GnRHR and the pattern of MRI enhancement in ordinary and cellular leiomyomas respectively. Conclusion 1.Most ordinary leiomyomas show slight hypointensity or isointensity on T1- weighted images, homogenous hypointensity on T2- weigthed images and no homogenously significant enhancement. Most cellular leiomyomas show isointensity on T1- weighted images, hyperintensity on T2- weigthed images, and homogenously significant enhancement. 2. The biological behaviour of cellular leiomyoma without increased karyokinesis activity is similar to the benign smooth muscle tumor. 3. Medical management of uterine leiomyoma by GnRHa may rely upon an directly antiproliferative effect via GnRHR expressed by leiomyoma. MRI helps screen cellular leiomyoma, which expresses more GnRHR and is more responsive to GnRHa. 4. Leiomyoma may not respond to hypoxia or tissue growth by an increase in microvessel density. Antiangiogenic agents would have limited therapeutic value in uterine leiomyoma. 5. Because of more GnRHR, uterine leiomyoma which shows homogenously significant enhancement on MRI may be more responsive to GnRHa.