Advances in uterine leiomyoma research: the progesterone hypothesis.
Uterine leiomyomas are monoclonal tumors. However, the factors involved in their initiation and growth remain poorly understood. The neoplastic transformation of myometrium to leiomyoma likely involves somatic mutations of normal myometrium and the complex interactions of sex steroids and local growth factors. Traditionally, estrogen has been considered the major promoter of myoma growth. The purpose of this review is to highlight the biochemical, histologic, and clinical evidence that supports an equally important role for progesterone in the growth of uterine myomas. Biochemical studies suggest that progesterone, progestins, and the progesterone receptor modulate myoma mitotic activity. A hypothesis to explain the pathogenesis of myomas is presented.
Rein
M S
MS
North Shore Medical Center, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts 01970-2370, USA. rein@nsmc.partners.org
D002471:Cell Transformation, Neoplastic / Q000235:genetics; D005260:Female; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006133:Growth Substances / Q000502:physiology; D006801:Humans; D007889:Leiomyoma / Q000209:etiology*; D008938:Mitosis / Q000502:physiology; D009154:Mutation / Q000235:genetics; D011374:Progesterone / Q000502:physiology*; D011372:Progestins / Q000502:physiology*; D011980:Receptors, Progesterone / Q000502:physiology*; D014594:Uterine Neoplasms / Q000209:etiology*
D012739:Gonadal Steroid Hormones; D006133:Growth Substances; D011372:Progestins; D011980:Receptors, Progesterone; D011374:Progesterone