Stewart E A, Nowak R A
Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Obstet Gynecol. 1998 Oct;92(4 Pt 1):624-7. doi: 10.1016/s0029-7844(98)00243-9.
Uterine leiomyomas are a common clinical occurrence for gynecologists. The current approach to treating these neoplasms is shaped by classic surgical principles and the knowledge that these tumors are responsive to the gonadal steroids estrogen and progesterone. As knowledge of leiomyomas advances through the techniques of molecular biology and molecular genetics, new concepts are developed that go beyond just myomas as steroid-responsive tumors. Understanding the molecular events involved in the transformation of a normal myometrial cell into a neoplastic cell and the subsequent growth of these leiomyoma cells will be important in determining the pathogenesis of these tumors and providing new targets for treatment. Knowing the role of peptide growth factors, including basic fibroblast growth factor and transforming growth factor-beta, in the pathogenesis of leiomyoma-related symptoms might lead to new treatments targeting these molecules or their receptors. As the effects of genes, including HMGIC and HMGI(Y), are determined; new treatments to prevent leiomyoma formation or growth may be developed. As we gain understanding of the molecular events that cause benign gynecologic conditions such as leiomyomas, safer and more effective treatments might be found as we enter the 21st century.
子宫平滑肌瘤是妇科医生临床中常见的病症。目前治疗这些肿瘤的方法是由经典外科原则以及这些肿瘤对性腺类固醇雌激素和孕激素有反应这一认知所决定的。随着通过分子生物学和分子遗传学技术对平滑肌瘤的认识不断深入，新的概念得以发展，这些概念不再仅仅将肌瘤视为对类固醇有反应的肿瘤。了解正常子宫肌层细胞转变为肿瘤细胞以及随后这些平滑肌瘤细胞生长过程中涉及的分子事件，对于确定这些肿瘤的发病机制以及提供新的治疗靶点至关重要。了解包括碱性成纤维细胞生长因子和转化生长因子-β在内的肽生长因子在平滑肌瘤相关症状发病机制中的作用，可能会带来针对这些分子或其受体的新治疗方法。随着包括HMGIC和HMGI(Y)在内的基因作用被确定，可能会研发出预防平滑肌瘤形成或生长的新治疗方法。当我们深入了解导致诸如平滑肌瘤等良性妇科疾病的分子事件时，在进入21世纪之际，或许能找到更安全、更有效的治疗方法。
