Sharara F I, Nieman L K
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
Am J Obstet Gynecol. 1995 Sep;173(3 Pt 1):814-9. doi: 10.1016/0002-9378(95)90346-1.
Uterine leiomyomas are the most common pelvic tumors, occurring in one of four women, and they represent the single most common indication for hysterectomy. The genesis and growth-promoting factors responsible for their development are poorly understood. We speculate that growth hormone may play a role in the initiation of these tumors; women with acromegaly have a higher incidence of leiomyomas and growth hormone promotes uterine growth in rats, with or without the addition of estradiol. We evaluated the presence of growth hormone receptor messenger ribonucleic acid in the human uterus and leiomyomas to investigate whether growth hormone might act directly rather than by hepatic generation of insulin-like growth factor-I.
Paired samples of leiomyomas and adjacent normal myometrium from nine premenopausal women (32 to 52 years old) were collected at surgery. Three patients received a gonadotropin-releasing hormone agonist for 3 months before the surgical procedure; six did not receive any adjuvant therapy. We used a digoxigenin-labeled oligoprobe sharing no homology to the growth hormone-binding protein or to the prolactin receptor, to investigate whether growth hormone receptor messenger ribonucleic acid was present in tissue sections or amplified complementary deoxyribonucleic acid from leiomyoma and the surrounding myometrium.
The ratios of growth hormone receptor/reduced glyceraldehyde-phosphate dehydrogenase in leiomyomas and the surrounding myometrium as assessed by densitometry analysis of polymerase chain reaction products were similar and were not altered by gonadotropin-releasing hormone agonist treatment. In situ hybridization localized the growth hormone receptor messenger ribonucleic acid to the nuclei and cytoplasm of leiomyoma and myometrium.
The presence of growth hormone receptor messenger ribonucleic acid suggests that the human uterus is a target tissue for growth hormone action. Future investigations are needed to investigate further the role of growth hormone in the development of leiomyomas.
子宫平滑肌瘤是最常见的盆腔肿瘤，每四名女性中就有一人患病，是子宫切除术最常见的单一指征。其发生及生长促进因素尚不清楚。我们推测生长激素可能在这些肿瘤的发生中起作用；肢端肥大症女性患平滑肌瘤的发生率更高，且生长激素可促进大鼠子宫生长，无论是否添加雌二醇。我们评估了人子宫及平滑肌瘤中生长激素受体信使核糖核酸的存在情况，以研究生长激素是否可能直接起作用，而非通过肝脏生成胰岛素样生长因子 -I 起作用。
在手术时收集了 9 名绝经前女性（32 至 52 岁）的平滑肌瘤及相邻正常肌层的配对样本。3 名患者在手术前 3 个月接受促性腺激素释放激素激动剂治疗；6 名未接受任何辅助治疗。我们使用与生长激素结合蛋白或催乳素受体无同源性的地高辛标记寡核苷酸探针，研究生长激素受体信使核糖核酸是否存在于平滑肌瘤及周围肌层的组织切片或扩增互补脱氧核糖核酸中。
通过聚合酶链反应产物的光密度分析评估，平滑肌瘤及周围肌层中生长激素受体/磷酸甘油醛脱氢酶的比值相似，且不受促性腺激素释放激素激动剂治疗的影响。原位杂交将生长激素受体信使核糖核酸定位在平滑肌瘤和肌层的细胞核及细胞质中。
生长激素受体信使核糖核酸的存在表明人子宫是生长激素作用的靶组织。需要进一步研究以探讨生长激素在平滑肌瘤发生中的作用。
