Prediction of the shrinking rate of uterine leiomyoma nodules using needle biopsy specimens
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Published on: July 25, 2015
Mari Kasai1, Tomoyuki Ichimura, Naoki Kawamura
1Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan. mari_k0410@yahoo.co.jp
Objective:
To determine correlations between shrinkage of uterine leiomyomas after treatment with GnRH agonists (GnRH-a) or menopause and expression levels of estrogen receptors (ER), progesterone receptors (PR), and vascular endothelial growth factor (VEGF).
Design:
Cohort study.
Setting:
University teaching hospital.
Patient(S):
A total of 26 women with uterine leiomyoma.
Intervention(S):
Ten women were treated with buserelin acetate injection (1.8 mg), four courses every 4 weeks, and 16 women went into menopause naturally.
Main Outcome Measure(S):
Tumor shrinkage rates determined from magnetic resonance images taken before and after GnRH-a therapy and before and after natural menopause; immunohistochemical analysis of ER, PR, and VEGF in uterine leiomyoma biopsy specimens taken before intervention or within 6 months before menopause.
Result(S):
Shrinkage rates of uterine leiomyomas were positively correlated with expression levels of ER in women treated with GnRH-a and in postmenopausal women managed conservatively, and with VEGF expression in women treated with GnRH-a. There were no significant correlations with PR expression levels in either group.
Conclusion(S):
Estrogen plays the predominant role in myoma shrinkage for women with GnRH-a therapy and naturally menopausal women.
