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

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

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.

Volume 98, Issue 2 , Pages 440-443, August 2012

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.

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