Morphological characteristics of myoma and endometrial tissue in patients with uterine leiomyoma after treatment with ulipristal acetate
Keywords:uterus leiomyoma, ulipristal acetate, progesterone receptors, proliferative activity, apoptosis, endometrium changes
Uterine leiomyoma is a hormone-dependent tumor of the myometrium, one of the most common benign tumors of the female genital organs. For conservative treatment of uterine leiomyoma different progesterone receptor blockers are used. One such drug is ulipristal acetate, a selective modulator of progesterone receptors, which suppress fibroid growth and may lead to its regression.
The aim a selective modulator of progesterone receptors, which suppress fibroid growth and may lead to its regression. The aim of research was to conduct morphological study of myoma and endometrial tissue in patients with uterine leiomyoma after treatment with ulipristal acetate. Histological and immunohistochemical study of leiomyoma and endometrium in 9 patients after three months of ulipristal acetate treatment 5 mg per day (the main group) and 15 patients without hormone therapy (control group) was conducted.
In patients treated with ulipristal acetate in smooth muscle cells of uterine noted a significant decrease of progesterone receptor expression, markers of apoptosis inhibitor Bcl-2 and proliferative activity Ki-67. Thus, in uterine smooth muscle cells under influence ulipristal acetate is a reduction amount of the progesterone receptor, i.e. decreases its action, resulting in the induction of apoptosis and reduced proliferation processes, whereby the uterine involution occurs. In the endometrium under the influence of ulipristal acetate develop reversible changes associated with the use of progesterone receptor modulators. In the study of proliferative activity marker Ki-67 in endometrium in patients receiving ulipristal acetate, we found its expression is very low compared with the group of patients without hormonal treatment of uterine leiomyoma.
The changes in the endometrium under the action of ulipristal acetate must be differentiated from the estrogen-induced changes and endometrial hyperplasias, so the direction of the pathological examination must be necessary indicate that a patient received ulipristal acetate therapy.
In the future, it is necessary to continue to study morphological changes, such as immunohistochemical characteristics of myoma and endometrial tissue in patients after treatment with ulipristal acetate.
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Copyright (c) 2015 Елена Георгиевна Курик, О. О. Литвак, Б. В. Хабрат, Б. М. Лисенко
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