A.A. TYURINA¹, A.G. YASHCHUK¹, R.A. NAFTULOVICH¹, Sh.M. KHUSNUTDINOV²

¹Bashkir State Medical University, 3 Lenin St., Ufa, Russian Federation, 450000

²Republic Clinical Oncology Dispensary, 73/1 Oktyabrya Pr., Ufa, Russian Federation, 450054 

Tyurina A.A. ― postgraduate student of the Department of Obstetrics and Gynecology №2, tel. +7-917-418-62-22, e-mail: alla.tyurina2016@yandex.ru

Yashchuk A.G. ― D. Med. Sc., Professor, Head of the Department of Obstetrics and Gynecology №2, tel. (347) 264-96-50, e-mail: alfiya_galimovna@mail.ru

Naftulovich R.A. ― Cand. Med. Sc., Associate Professor of the Department of Obstetrics and Gynecology №2, tel. (347) 264-96-50, e-mail: raisanaftulovich@mail.ru

Khusnutdinov Sh.M. ― Cand. Med. Sc., Head of the Department of Pathological Anatomy, tel. (347) 216-36-71, e-mail: shamilkhusn@mail.ru 

The article presents the results of immunohistochemical study of expression of estrogen and progesterone receptors in the tissues of fibroids during and out of pregnancy, as well as immunohistochemistry determined proliferative activity of smooth muscle cells in myoma nodes during and out of pregnancy by determining the number of positively stained nuclei containing Ki-67 protein. The study revealed that in leiomyomata tissues obtained from women during pregnancy, the expression of the receptors of the sex steroidal hormones and smooth muscle cell proliferation activity are significantly lower than in leiomyomata tissues obtained from non-pregnant women in the proliferative phase of the menstrual cycle. The findings of the study prove that the growth of fibroids during pregnancy develops mainly due to muscle cells hypertrophy and extracellular matrix accumulation.

Key words: leiomyomata uteri, immunohistochemical analysis, cell-proliferation index, pregnancy, sex steroidal receptors.

 

 

REFERENCES

1. Buyanova S.N., Yudina N.V., Gukasyan S.A. Modern aspects of uterine fibroid growth. Rossiyskiy vestnik akushera-ginekologa, 2012, 12 (4), pp. 42-48 (in Russ.).

2. Sidorova I.S., Unanyan A.L., Ageev M.B. et al. The current state of the question of the pathogenesis, clinical manifestations, diagnosis and treatment of uterine mimes in women of reproductive age. Akusherstvo. Ginekologiya. Reproduktsiya, 2012, vol. 6, no. 4 (in Russ.).

3. Ishchenko A.I., Botvin M.A., Lanchinskiy V.I. Mioma matki: etiologiya, patogenez, diagnostika, lechenie [Uterine fibroids: etiology, pathogenesis, diagnosis, treatment]. Moscow, 2010. Pp. 6-9, 19-27.

4. Kiselev V.I., Sidorova I.S., Unanyan A.L. Giperplasticheskie protsessy organov zhenskoy reproduktivnoy sistemy: teoriya i praktika [Hyperplastic processes of female reproductive system: theory and practice]. Moscow, 2011. Pp. 26-37, 57-79.

5. Sidorova I.S., Unanyan A.L., Kogan E.A., Guriev T.D. Uterine fibroids in young patients: clinical and pathogenetic features. Akusherstvo, ginekologiya i reproduktsiya, 2010, no. 1, pp. 16-20 (in Russ.).

6. Chabbert-Buffet N., Esber N., Bouchard P. Fibroid growth and medical options for treatment. Fertil. Steril, 2014, vol. 102 (3), pp. 630-639.

7. Ciavattini A., Di Giuseppe J., Stortoni P., Montik N. et al. Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction. Hindawi Publishing Corporation Obstetrics and Gynecology International, 2013, article ID 173184, 11 p, available at: http://dx.doi.org/10.1155/2013/173184

8. Tikhomirov A.L. Modern principles of therapeutic treatment of uterine fibroids. Effektivnaya farmakoterapiya, 2015, no. 5 (in Russ.).

9. Chayka K.V. Current concepts of etiology, pathogenesis and morphogenesis of uterine fibroids. Med.-sots. probl. sіm’ї, 2012, vol. 17, no.1, pp. 88-96 (in Russ.).

10. Ning S., Shi-You C. Mechanisms simultaneously regulate smooth muscle proliferation and differentiation. The J. of Biomedical Research, 2014, vol. 28 (1), pp. 40-46.

11. Hermon T.L., Moore A.B., Yu L., Kissling G.E., et al. Estrogen receptor alpha (ERα) phospho-serine-118 is highly expressed in human uterine leiomyomas compared to matched myometrium. Virchows Arch, 2008, Dec, 453 (6), pp. 557-569, doi:10.1007/s00428-008-0679-5

12. Hewedi I.H., Radwan N.A. Shash L.A. Diagnostic value of progesterone receptor and p53 expression in uterine smooth muscle tumors. Diagnostic Pathology, 2012, 7, 1, available at: http://www.diagnosticpathology.org/content/7/1/1

13. Medvedev M.V. Immunohistochemical evaluation of leiomyoma tissue and normal myometrium in patients with uterine leiomyoma during hypo- and hyperestrogenic conditions caused by of use of gonadotropin-releasing hormone analogues. Morfologіya. – 2012. – vol. VІ, no.1. – pp. 43-49 .

14. Moravek M.B., Yin P., Ono M. et al. Ovarian steroids, stem cells and uterine leiomyoma: therapeutic implications. Hum. Reprod. Update, 2014 [Epub ahead of print.]

15. Petrovic D., Babic D., Forko J.I., Martinac I. Expression of Ki-67, p53 and progesterone receptors in uterine smooth muscle tumors: diagnostic value. Coll Antropol, 2010, 34 (1), pp. 93-7.

16. Plewka A., Madej P., Plewka D., Kowalczyk A. et al. Immunohistochemical localization of selected pro-inflammatory factors in uterine myomas and myometrium in women of various ages. Folia Histochem Cytobiol, 2013, 10.5603/FHC.2013.0011

17. Krasil’nikova A.K., Sotnikova N.Yu., Malyshkina A.I. et al. The role of cytokines produced by mononuclear cells of the endometrium in the development of the rapid growth of uterine fibroids. Aktual’nі pitannya pedіatrіі, akusherstva ta gіnekologіі, 2010, no. 1, pp. 115-118 (in Russ.).

18. Kustarov V.N., Tatarov A.S. The course of pregnancy, childbirth and the postpartum period in patients with simple and proliferating uterine myoma. Kazanskiy meditsinskiy zhurnal, 2010, vol. 91, no. 3, pp. 393-397 (in Russ.).

19. Plewka A., Plewka D., Madej P. et al. Processes of apoptosis and cell proliferation in uterine myomas originating from reproductive and perimenopausal women. Folia Histochem. Cytobiol, 2011, vol. 49, no. 3, rr. 398-404.

20. Antropova E.Yu., Tukhvatullina L.M. Role definition receptor status and vascularization of the uterine leiomyoma in the choice of treatment. Meditsinskiy al’manakh, 2009, no. 4 (9) (in Russ.).

21. Bekhtereva I.A., Gustovarova T.A., Shcherbakova L.A. et al. Features of expression of steroid hormones, proliferative activity, the area of the vascular bed in the uterine tissues when submucous fibroids and glandular endometrial hyperplasia. Vestnik VGMU, 2011, vol. 10, no. 2 (in Russ.).

22. Kirillina M.L. Immunohistochemical study of steroid hormone receptors in breast cancer. Aktual’nye voprosy eksperimental’noy i klinicheskoy onkologii, 2011, vol. 3, no. 2 (in Russ.).

23. Potapov V.A., Donskaya Yu.V., Medvedev M.V. Histological and immunohistochemical assessment of the myoma and endometrial tissue in patients with uterine leiomyoma and endometrial hyperplasia. Morfologiya, 2013, vol. VII, no. 2 (in Russ.).

24. Immunogistokhimicheskie metody: Rukovodstvo [Immunohistochemical Methods: Manual]. Ed. by George L. Kumar, Lars Rudbeck. Moscow, 2011. 224 p.

25. Chang C.C., Hsieh Y.Y., Lin W.H., Lin C.S. Leiomyoma and vascular endothelial growth factor gene polymorphisms: a systematic review. Taiwan J. Obstet. Gynecol, 2010, vol. 49, no. 3, rr. 247-253.