Gutmann J N, Thornton K L, Diamond M P, Carcangiu M L
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
Fertil Steril. 1994 Apr;61(4):622-6.
To determine if short-term, preoperative leuprolide acetate (LA) therapy alters the histologic appearance of uterine leiomyomata.
Retrospective evaluation by a pathologist (who was blinded to patient history) of the histologic features of leiomyomata excised from 36 women, 12 who received preoperative LA and 24 age-matched controls.
Yale-New Haven Hospital, New Haven, Connecticut, from September 1989 to September 1990.
The histologic specimens were evaluated for the presence of mitotic activity, cellular atypia, cellularity, and secondary changes including edema, fibrosis, calcification, hemorrhage, infarction, hyalinization, and vascular appearance.
Of the 12 patients treated with LA, 10 (84%) demonstrated a reduction in uterine volume after 3 to 6 months of LA therapy. There was no difference in any of the histopathologic parameters evaluated between the LA-treated group and the untreated group. Exclusion of leiomyoma, which did not have a reduction in size during LA therapy, did not alter the analysis. Among patients treated with LA, those leiomyoma that did not respond to LA had a greater degree of hyalinization than those that responded.
Reduction in uterine size by short-term LA therapy did not detectably alter histologic appearance of leiomyoma.
确定术前短期使用醋酸亮丙瑞林（LA）治疗是否会改变子宫平滑肌瘤的组织学外观。
由一名病理学家（对患者病史不知情）对36名女性切除的平滑肌瘤的组织学特征进行回顾性评估，其中12名接受术前LA治疗，24名年龄匹配的对照者。
1989年9月至1990年9月，康涅狄格州纽黑文市的耶鲁-纽黑文医院。
评估组织学标本中是否存在有丝分裂活性、细胞异型性、细胞密度以及包括水肿、纤维化、钙化、出血、梗死、透明变性和血管外观在内的继发性改变。
在接受LA治疗的12名患者中，10名（84%）在LA治疗3至6个月后子宫体积减小。LA治疗组和未治疗组之间评估的任何组织病理学参数均无差异。排除LA治疗期间体积未减小的平滑肌瘤，并未改变分析结果。在接受LA治疗的患者中，对LA无反应的平滑肌瘤比有反应的平滑肌瘤透明变性程度更高。
短期LA治疗使子宫体积减小并未显著改变平滑肌瘤的组织学外观。
