title: Relationship between platelet-derived growth factor expression in leiomyomas and uterine volume changes after gonadotropin-releasing hormone agonist treatment.
abstract: The unopposed estrogen effect is the main cause of leiomyoma growth and is at the basis of the clinical use of gonadotropin-releasing hormone (GnRH) agonists. Platelet-derived growth factor (PDGF) has been indicated as the main growth factor involved, in vitro in the proliferation response of leiomyoma smooth muscle cells to estrogen stimulation. The aim of this article is to evaluate the mitogenic action of PDGF in vivo by studying the relationship between PDGF expression in leiomyomas and post-GnRH analogue treatment changes in uterine volume. Thirty-nine patients suffering from uterine leiomyomas were treated with leuprorelin acetate depot 3.75 mg for three cycles; 31 untreated patients were enrolled as control group. Uterine volume was determined twice by ultrasonography in each patient, the first time at admission and the second time after treatment in the study group and after 3 months in the control group. The change in the uterine volume was then evaluated. Patients underwent surgery, and PDGF immunohistochemical detection was performed on the obtained fibroid samples. Uterine volume decreased significantly after treatment, whereas just a poor modification was found in the controls. The decrease in the uterine volume was found to be statistically related to PDGF expression. Thus PDGF levels decreased in treated patients as compared with controls. The decreased PDGF production in leiomyomas after GnRH analogue treatment and the relationship between decreased PDGF expression and greater shrink age in uterine volume suggest that PDGF might have a mitogenic action on leiomyomas in vivo.
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, University Federico II, Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lieto
authors.forename: Gaetano
authors.initials: G
authors.lastname: De Rosa
authors.forename: Marianna
authors.initials: M
authors.lastname: De Falco
authors.forename: Francesca
authors.initials: F
authors.lastname: Iannotti
authors.forename: Stefania
authors.initials: S
authors.lastname: Staibano
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pollio
authors.forename: Mariangela
authors.initials: M
authors.lastname: Scaramellino
authors.forename: Gaetano
authors.initials: G
authors.lastname: Salvatore
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000737:chemistry* / Q000188:drug therapy* / Q000473:pathology; D016729:Leuprolide / Q000627:therapeutic use*; D010982:Platelet-Derived Growth Factor / Q000032:analysis*; D017697:Premenopause; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000737:chemistry* / Q000188:drug therapy* / Q000473:pathology; D014599:Uterus / Q000473:pathology
chemical_list: D018931:Antineoplastic Agents, Hormonal; D010982:Platelet-Derived Growth Factor; D016729:Leuprolide