Ciebiera Michał, Jakiel Grzegorz, Nowicka Grażyna, Laganà Antonio Simone, Ghezzi Fabio, Łoziński Tomasz, Wojtyła Cezary, Włodarczyk Marta
II Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland.
I Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland.
Arch Med Sci. 2020 Apr 8;20(3):751-761. doi: 10.5114/aoms.2020.94296. eCollection 2024.
Uterine fibroids (UFs) are benign tumors of the female reproductive system originating from the smooth muscle of the uterus. Currently, progesterone is known to play a key role in the differentiation of the myometrial tissue to form UFs and their abnormal growth. The mechanism of action of progesterone in UF tumorigenesis involves its effect on increasing the concentrations and dysregulation of selected growth factors.
A retrospective cohort study was performed to evaluate and compare tumor necrosis factor α (TNF-α), insulin-like growth factor 1 (IGF-1), plasminogen activator inhibitor-1 (PAI-1) serum concentrations in patients with UFs without prior hormonal treatment, patients with UFs treated with a 3-month standard ulipristal acetate (UPA - a type of selective progesterone receptor modulator) scheme (5 mg/day) and in control patients without UFs. A total of 120 patients were divided into 3 groups (controls, UFs with UPA treatment, UFs without UPA treatment).
There were no significant differences in TNF-α serum concentrations between patients with UFs who underwent UPA treatment and patients who did not. Serum concentrations of IGF-1 and PAI-1 did not show significant intergroup differences.
No significant differences were found between TNF-α concentrations in the serum of patients with UFs treated with UPA, and patients without UPA treatment. In addition, our data analysis did not show significant differences in the concentrations of IGF-1 and PAI-1 between patients with UFs and the control group. Further studies on the dependence of specific symptoms on selected growth factors are mandatory.
子宫肌瘤（UFs）是起源于子宫平滑肌的女性生殖系统良性肿瘤。目前已知孕酮在子宫肌层组织分化形成子宫肌瘤及其异常生长过程中起关键作用。孕酮在子宫肌瘤发生中的作用机制涉及其对增加特定生长因子浓度及失调的影响。
进行了一项回顾性队列研究，以评估和比较未接受过激素治疗的子宫肌瘤患者、接受为期3个月标准醋酸乌利司他（UPA - 一种选择性孕酮受体调节剂）方案（5毫克/天）治疗的子宫肌瘤患者以及无子宫肌瘤的对照患者的肿瘤坏死因子α（TNF-α）、胰岛素样生长因子1（IGF-1）、纤溶酶原激活物抑制剂-1（PAI-1）血清浓度。总共120名患者被分为3组（对照组、接受UPA治疗的子宫肌瘤患者、未接受UPA治疗的子宫肌瘤患者）。
接受UPA治疗的子宫肌瘤患者与未接受治疗的患者之间，TNF-α血清浓度无显著差异。IGF-1和PAI-1的血清浓度在组间未显示出显著差异。
接受UPA治疗的子宫肌瘤患者血清中的TNF-α浓度与未接受UPA治疗的患者之间未发现显著差异。此外，我们的数据分析未显示子宫肌瘤患者与对照组之间IGF-1和PAI-1浓度存在显著差异。必须对特定症状与选定生长因子之间的相关性进行进一步研究。
