Prediction of the shrinking rate of uterine leiomyoma nodules using needle biopsy specimens

Shrinkage of uterine leiomyoma after GnRH-a therapy or menopause is positively correlated with ER levels and VEGF.

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Authors

Mari Kasai, M.D., Tomoyuki Ichimura, M.D., Ph.D., Naoki Kawamura, M.D., Ph.D., Tomoko Sumikura, M.D., Makiko Matsuda, M.D., Chika Asano, M.D., Ph.D., Toshiyuki Sumi, M.D., Ph.D., Osamu Ishiko, M.D., Ph.D.

Vol 98, Issue 2 , Pages 440-443

Abstract

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.

Read the full text at: http://www.fertstert.org/article/S0015-0282(12)00567-5/fulltext


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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