The Expression And Significance Of ER,PR And HMGA In Uterine Leiomyomas

Objective: Uterine leiomyomas(fibroids, myomas) are the most common reproductive tract neoplasm in women, the occurrence and progression of which are associated not only with the level of hormal but also with the factor of heredity, reproduction and environment, it is the outcome of many factors acting together. The purpose of this study was to explore the etiology of leiomyomas by detecting the expression of ER,PR and HMGA in leiomyomas and normal matched myometriums.Materials and Methods: 1 A total of 50 patients with B-ultrasound-proven uterine leiomyoma were selected, serum E2 and P of every patients had been detected one day before the operation. 2 After the operation, the specimens of both leiomyoma and normal matched myometrium were collected, fixed in 10% neutral buffered formalin, embedded in paraffin, and cut into 0.5μm thick slices. Using HE staining, pathology changes were observed; SP immunohistochemical staining were used to assess the expression of ER, PR and cyclinA at uterine leiomyomas and normal matched myometriums; ISH were used to assess the expression of HMGA1 mRNA and HMGA2 mRNA at uterine leiomyomas and normal matched myometriums; terminal deoxynucleotidyl transferase mediated dUTP nick-end-labeling (TUNEL) were used to assess the apoptotic cells at uterine leiomyomas and normal matched myometriums. The data obtained were analyzed by using Student t test and product moment correlation.Results: (1) In uterine leiomyoma patients, serum E2 was 174.65±84.01 Pmol/L in proliferation phase, and 446.65±168.63 Pmol/L in secretory phase, contrast with normal women, there were not significant differences (p>0.05); serum P was 2.50±1.18 nmol/L in proliferation phase, and 24.16±15.31 nmol/L in secretory phase, contrast with normal women, there were not significant differences (p>0.05). The expression of ER and PR was detected in all specimens. In uterine leiomyoma specimens, the number of positive cells of ER and PR was 444.4±117.84/mm2,338.0±76.5/mm2 in proliferation phase；and 300.4±47.94/mm2,686.8±32.4/mm2 in secretory phase, respectively; while in normal myometrium specimens, the number of positive cells of ER and PR was 229.6±34.32/mm2,87.6±28.0/mm2 in proliferation phase；and 141.0±39.18/mm2,238.8±33.3/mm2 in secretory phase. The number of ER and PR positive cells were significantly higher in uterine leimyomas than those in normal myometriums (P<0.05). Further, the number of ER positive cells were significantly higher in proliferation phase than those in secretory phase (P<0.05); the number of PR positive cells were significantly higher in secretory phase than those in proliferation phase (P<0.05). (2) The positive rate of HMGA1 and HMGA2 was 90% and 60% in uterine leiomyomas, respectively; while in normal myometriums the positive rate was 46% and 0%, respectively. There were significant differences of these data between two groups (P<0.05). In uterine leiomyomas, the number of positive cells of HMGA1 and HMGA2 was 25.2±8.01/mm2, 40.8±10.46/mm2 in proliferation phase, and 35.6±13.53/mm2, 47.2±10.80/mm2 in secretory phase, respectively; while in normal myometrium, the number of positive cells of HMGA1 and HMGA2 was 16.4±6.38/mm2, 0/mm2 in proliferation phase; and 20.8±9.00/mm2, 0/mm2 in secretory phase, respectively. There were significant differences of these data between two groups (P<0.05). The number of positive cells and the positive rate of HMGA1 and HMGA2 were not associated with menstrual cycle. (3) The number of positive cells of cyclinA was 27.2±9.76/mm2 in uterine leiomyomas,and 16.8±7.25/mm2 in normal myometrial, there were significant differences of these data between two groups (P<0.05). The number of apoptotic cells in uterine leiomyoma was 0/HPF,and 0.43±0.50/HPF in normal myometrial. (4) The coefficient of product moment correlation between positive cells of cyclinA and HMGA1, HMGA2 was 0.820 and 0.869 in uterine leiomyomas, respectively. There was a significant positive-correlation between them (P<0.001).Conclusions: (1) The asso...