Pathologic evaluation of uterine leiomyoma treated with radiofrequency ablation.
OBJECTIVE
To explore the mechanism by which radiofrequency ablation (RFA) treats uterine leiomyoma by observing the features of the lesions caused by RFA to leiomyoma tissue.


METHODS
Specimens from treated lesions were observed after hysterectomy was performed immediately (acute test) or on the third day (chronic test) following treatment in 2 groups of 30 patients. Histopathologic studies were also performed for all specimens, with untreated specimens as controls.


RESULTS
For the acute and chronic tests, specimens from the RFA-treated lesions included the center segment (group 1); the marginal segment (group 2); the segment 1-cm away from the margin (group 3); and the segment 2-cm away from the margin (group 4). In the acute test, group 1 showed a sharply demarcated area of coagulative necrosis that did not express estrogen receptor (ER) or progesterone receptor (PR); group 2 showed a severe hydropic degeneration or necrosis; and group 3 showed regular leiomyoma cells. The expression of ER and PR was significantly less in groups 2 and 3 than in the control group (P<0.05), but ER and PR expression in group 4, which had normal leiomyoma cells, was the same as in the control group (P>0.05). In the chronic test, group 1 showed carbonization and coagulation necrosis without ER or PR expression. There was severe hemorrhage and thrombosis in group 2; hyaline degeneration and tissue granulation in group 3; and mild degeneration in group 4. The expression of ER and PR was significantly lower in groups 2, 3, and 4 than in the control group (P<0.05).


CONCLUSIONS
Radiofrequency ablation might treat uterine leiomyomas by inducing coagulative necrosis and depressing ER and PR expression.
Luo
Xin
X
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, China. tluox@126.com
Shen
Yuan
Y
Song
Wen-Xia
WX
Chen
Pei-wen
PW
Xie
Xing-mei
XM
Wang
Xiao-yu
XY
D000328:Adult; D016022:Case-Control Studies; D017115:Catheter Ablation; D005260:Female; D005786:Gene Expression Regulation; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D006818:Hyalin / Q000378:metabolism; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology / Q000473:pathology; D011960:Receptors, Estrogen / Q000235:genetics / Q000378:metabolism; D011980:Receptors, Progesterone / Q000235:genetics / Q000378:metabolism; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery
D011960:Receptors, Estrogen; D011980:Receptors, Progesterone