Trojnar-Podleśny Magdalena, Reroń Alfred
Kliniki Ginekologii i Połoznictwa Septycznego, Collegium Medicum UJ, Kraków.
Ginekol Pol. 2003 Dec;74(12):1572-7.
Uterine leiomyomas are benign tumours that arise from the smooth-muscle cells of the human uterus. They are clinically apparent in up to 20% of women and cause significant morbidity, including prolonged and heavy menstrual bleeding, pelvic pressure or pain and reproductive dysfunction. Surgery has been the mainstay of fibroid treatment and various minimally invasive procedures have been developed in addition to hysterectomy and abdominal myomectomy, but formation of new leiomyomas after these conservatives therapies remains a substantial problem. The pathophysiology of myomas is not well understood. We present some views of epidemiological, reproductive and environmental factors, which may stimulate myomas formation. We also present a brief survey of the literature about genetic predisposition, mutations, steroid hormone and growth factors concentration, which seems to pay an important role in fibrotic processes and angiogenesis observed during formation and growth of these tumours. New research into the basic biology of these neoplasms may add new treatment options for the future as the role of growth factors and genetic mutations in these tumours are better understood.
子宫平滑肌瘤是源自人类子宫平滑肌细胞的良性肿瘤。临床上,高达20%的女性会出现子宫平滑肌瘤,它会导致严重的发病率,包括经期延长和经量过多、盆腔压迫感或疼痛以及生殖功能障碍。手术一直是子宫肌瘤治疗的主要手段,除了子宫切除术和腹部肌瘤切除术外,还开发了各种微创手术,但这些保守治疗后新肌瘤的形成仍然是一个重大问题。子宫肌瘤的病理生理学尚未完全了解。我们提出了一些关于流行病学、生殖和环境因素的观点,这些因素可能刺激肌瘤的形成。我们还简要综述了有关遗传易感性、突变、类固醇激素和生长因子浓度的文献,这些因素似乎在这些肿瘤形成和生长过程中观察到的纤维化过程和血管生成中起重要作用。随着对这些肿瘤中生长因子和基因突变作用的更好理解,对这些肿瘤基本生物学的新研究可能为未来增添新的治疗选择。