Shen Minghong, Duan Hua, Chang Yanan, Wang Sha
Department of Minimally Invasive Gynecologic Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Department of Gynecology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, Fujian Province, China.
Menopause. 2021 Sep 7;28(11):1209-1213. doi: 10.1097/GME.0000000000001846.
The aim of this study was to examine the growth of uterine leiomyomas in postmenopausal women and evaluate the influencing factors associated with fibroid growth.
We retrospectively analyzed the medical records of postmenopausal women with fibroids between 2015 and 2020. All women received at least 2 transvaginal ultrasound examinations within a 6-month interval. All fibroids were verified via surgery. The postoperative pathology of all tumors was uterine fibroid. We calculated the fibroid volume using the ellipsoid volume formula and evaluated the growth rate of fibroids within 6 months simultaneously. Univariable analysis and a linear mixed-effects model were used to assess the factors influencing fibroid growth.
A total of 102 postmenopausal women with a total of 132 fibroids were assessed. The median growth rate of surgically confirmed fibroids in postmenopausal women was 12.9% every 6 months (from -61.4% to 184.1%). Obesity was associated with fibroid growth (P < 0.05). Notably, the estimated growth rates of fibroids in obese and overweight women were 26.6% (95% confidence interval [CI]: 2.3-50.9) and 15.9% (95% CI: 0.4-31.4) higher than those in women of normal weight, respectively. The growth of fibroids varied by the initial tumor size (P < 0.05). The estimated growth rate of larger fibroids (≥5.0 cm diameter) was reduced 30.0% (95% CI: -52.4 to -7.5) compared with that of small fibroids (<3.0 cm diameter).
Uterine fibroids continually grow in some postmenopausal women. Obesity and small fibroids (<3.0 cm diameter) may contribute to higher growth rates of fibroids.
本研究旨在探讨绝经后女性子宫平滑肌瘤的生长情况，并评估与肌瘤生长相关的影响因素。
我们回顾性分析了2015年至2020年间患有肌瘤的绝经后女性的病历。所有女性在6个月内至少接受了2次经阴道超声检查。所有肌瘤均通过手术进行了确认。所有肿瘤的术后病理均为子宫肌瘤。我们使用椭球体体积公式计算肌瘤体积，并同时评估6个月内肌瘤的生长速率。采用单变量分析和线性混合效应模型来评估影响肌瘤生长的因素。
共评估了102名绝经后女性，她们共有132个肌瘤。绝经后女性经手术确认的肌瘤的中位生长速率为每6个月12.9%（范围为-61.4%至184.1%）。肥胖与肌瘤生长相关（P<0.05）。值得注意的是，肥胖和超重女性肌瘤的估计生长速率分别比正常体重女性高26.6%（95%置信区间[CI]：2.3-50.9）和15.9%（95%CI：0.4-31.4）。肌瘤的生长因初始肿瘤大小而异（P<0.05）。与小肌瘤（直径<3.0 cm）相比，较大肌瘤（直径≥5.0 cm）的估计生长速率降低了30.0%（95%CI：-52.4至-7.5）。
一些绝经后女性的子宫肌瘤会持续生长。肥胖和小肌瘤（直径<3.0 cm）可能导致肌瘤更高的生长速率。
