Estrogen and progesterone receptor content of GnRH analogue pretreated and untreated uterine leiomyomata

Eur J Obstet Gynecol Reprod Biol. 1995 Nov;63(1):69-73. doi: 10.1016/0301-2115(95)02219-w.

Abstract

Objectives: The steroid receptor concentration and the histological morphology of uterine leiomyomata in premenopausal patients undergoing myomectomy therapy with and without a preoperative GnRH analogue, was analysed to evaluate whether the GnRH analogue therapy leads to important hormonal receptor changes, histomorphological changes and a significant shrinkage of the leiomyomata.

Study design: Sixty-one GnRH analogue pretreated leiomyomata and 28 untreated leiomyomata were analysed. To determine the estrogen and progesterone receptor concentrations, immunohistochemical techniques were used and quantified with the immuno-reactive score (IRS-score). The leiomyomata were divided into cellular rich, normal, hyaline or cystic degenerated and necrotic according to their histology.

Results: The GnRH analogue pretreated leiomyomata group showed higher levels of estrogen and progesterone receptors than the untreated group (37.7% of the GnRH analogue group had a high positive and 29.5% a moderate positive estrogen receptor status whereas high levels of estrogen receptor could be found in only 14.3% of the untreated group). The leiomyomata of both groups with the exception of the necrotic ones, were estrogen and progesterone receptor positive.

Conclusions: Our study suggests that pretreatment of uterine leiomyomata leads to a significant increase in the hormonal receptor concentration of these benign tumors. If pretreated leiomyomata are not removed surgically immediately after the therapy, a rapid regrowth can occur and again cause clinical symptoms.

MeSH terms

  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Female
  • Humans
  • Immunohistochemistry
  • Leiomyoma / drug therapy
  • Leiomyoma / metabolism*
  • Leiomyoma / surgery
  • Leuprolide / therapeutic use*
  • Premenopause
  • Receptors, Estrogen / metabolism*
  • Receptors, Progesterone / metabolism*
  • Uterine Neoplasms / drug therapy
  • Uterine Neoplasms / metabolism*
  • Uterine Neoplasms / surgery

Substances

  • Antineoplastic Agents, Hormonal
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Leuprolide