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子宫纤维瘤病的病因发病机制。

The etiopathogenesis of uterine fibromatosis.

作者信息

Manta L, Suciu N, Toader O, Purcărea R M, Constantin A, Popa F

机构信息

Department of Gynecology and Obstetrics, "Gh. Polizu" Maternity, "Alfred Rusescu" Mother and Child Care Institute, Bucharest, Romania.

Department of Internal Medicine, "Carol Davila" Hospital, Bucharest, Romania.

出版信息

J Med Life. 2016 Jan-Mar;9(1):39-45.

Abstract

Uterine fibroids or uterine leiomyomas are the most common benign tumors of the uterus among women of fertile age, while the etiology is still incompletely elucidated. The occurrence and development of the fibromatosis may be related to certain risk factors and genic mechanisms, although the exact causes are not yet fully known. The development of uterine fibroids is correlated not only with the metabolism and with the level of female sexual hormones, estrogen, and progesterone, but also with the number of these hormone receptors expressed on the surface of the myometrium. Proliferative effects of estrogen and progesterone may be exercised through proinflammatory factors (TNF alpha), growth factors (IGF1, IGF2, TGFbeta3 and betaFGF) or inhibitors of apoptosis (p53 suppression). A number of predisposing factors such as ethnicity - black skin, early menarche, nulliparity, caffeine and alcohol, chronic inflammation, obesity, were also identified. Approximately 40% of the uterine fibroids are caused by the same cytogenetic alterations found in the other tumor types such as kidney, lung, or leiomyosarcoma. As part of a system dysfunction, uterine fibromatosis was connected to other disorders such as AHT (arterial hypertension), endometrium adenocarcinoma, adenomyosis, endometriosis, diabetes mellitus, breast tumors, seemingly with a common causality. The action and effect of some hormonal imbalances over the various organs depend on the histological and local expression particularities of the various receptors, being the cause for many disorders, among which the uterine fibromatosis, coexisting or accompanying the later. This article examines and summarizes the latest data refreshed literature etiopathogenesis offering indicators of uterine fibroids.

摘要

子宫肌瘤或子宫平滑肌瘤是育龄女性中最常见的子宫良性肿瘤,但其病因仍未完全阐明。虽然确切原因尚不完全清楚,但纤维瘤病的发生和发展可能与某些危险因素和基因机制有关。子宫肌瘤的发展不仅与新陈代谢以及女性性激素、雌激素和孕激素的水平有关,还与子宫肌层表面表达的这些激素受体的数量有关。雌激素和孕激素的增殖作用可能通过促炎因子(肿瘤坏死因子α)、生长因子(胰岛素样生长因子1、胰岛素样生长因子2、转化生长因子β3和碱性成纤维细胞生长因子)或凋亡抑制剂(p53抑制)来实现。还确定了一些诱发因素,如种族——黑皮肤、初潮早、未生育、咖啡因和酒精、慢性炎症、肥胖等。大约40%的子宫肌瘤是由在其他肿瘤类型如肾脏、肺部或平滑肌肉瘤中发现的相同细胞遗传学改变引起的。作为系统功能障碍的一部分,子宫纤维瘤病与其他疾病如动脉高血压、子宫内膜腺癌、子宫腺肌病、子宫内膜异位症、糖尿病、乳腺肿瘤有关,似乎存在共同的因果关系。某些激素失衡对各个器官的作用和影响取决于各种受体的组织学和局部表达特性,这是许多疾病的原因,其中包括子宫纤维瘤病,它与这些疾病并存或伴随出现。本文研究并总结了最新的数据,更新了有关子宫纤维瘤病因发病机制的文献,提供了相关指标。

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