title: Aberrant expression of apoptosis proteins and ultrastructural aberrations in uterine leiomyomas from patients with hereditary leiomyomatosis and renal cell carcinoma.
abstract: OBJECTIVE
  To examine differences between sporadic and familial uterine leiomyomata related to expression of apoptosis-related proteins and tumor ultrastructure.
  
  
  METHODS
  Expression of apoptosis-related proteins was measured by immunohistochemistry. Tumor ultrastructure was evaluated by transmission electron microscopy.
  
  
  METHODS
  Human genetics laboratory.
  
  
  METHODS
  Patients confirmed for hereditary leiomyomatosis and renal cell carcinoma (HLRCC), and anonymous archival sporadic leiomyoma patients.
  
  
  METHODS
  Samples for electron microscopy were collected from myomectomy and hysterectomy with informed consent. Other samples were archival.
  
  
  METHODS
  Intensity of immunohistochemistry staining and evaluation of electron micrographs.
  
  
  RESULTS
  Immunohistochemistry revealed increases in expression of antiapoptotic Bcl-2 and the proliferation factor proliferating cell nuclear antigen (PCNA) in both sporadic and HLRCC uterine leiomyomata. Furthermore, we observed an increase in antiapoptotic Bcl-x and a concurrent decrease in proapoptotic Bak solely in HLRCC leiomyomas. We also observed ultrastructural alterations in HLRCC and sporadic leiomyomas, particularly pertaining to extracellular matrix and intermediate filament aggregation.
  
  
  CONCLUSIONS
  The observed alterations in expression of apoptosis-related proteins indicate a shift in both HLRCC and sporadic leiomyomas to increased resistance to apoptosis compared with myometrium, which appears to be stronger in HLRCC leiomyomas. The changes observed in HLRCC leiomyomas appear to be related to activation of the hypoxia pathways. The results suggest not only a partial overlap in the pathogenic mechanism of the two tumor types, but also intriguing differences.
authors.affiliation: Molecular and Population Genetics Laboratory, Cancer Research UK, London, United Kingdom. noel.wortham@cancer.org.uk
authors.forename: Noel C
authors.initials: NC
authors.lastname: Wortham
authors.forename: N Afrina
authors.initials: NA
authors.lastname: Alam
authors.forename: Ella
authors.initials: E
authors.lastname: Barclay
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Pollard
authors.forename: Bart E
authors.initials: BE
authors.lastname: Wagner
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Manek
authors.forename: George
authors.initials: G
authors.lastname: Elia
authors.forename: Ian P M
authors.initials: IP
authors.lastname: Tomlinson
mesh_terms: D051017:Apoptosis Regulatory Proteins / Q000378:metabolism*; D002292:Carcinoma, Renal Cell / Q000378:metabolism* / Q000648:ultrastructure*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000378:metabolism / Q000648:ultrastructure; D007889:Leiomyoma / Q000151:congenital / Q000378:metabolism* / Q000648:ultrastructure*; D014018:Tissue Distribution; D014594:Uterine Neoplasms / Q000378:metabolism* / Q000648:ultrastructure*
chemical_list: D051017:Apoptosis Regulatory Proteins