Leiomyomata uteri: hormonal and molecular determinants of growth.
OBJECTIVE
To review the available English literature that examines the biology of leiomyoma uteri in African-American women and other ethnic groups. Factors that influence the growth and development of leiomyomas are examined to understand the basis for larger myomas in African-American women.


METHODS
Literature review of 176 articles regarding the pathobiology of leiomyoma in various ethnic groups.


RESULTS
The initiating factor(s) associated with the transformation of a normal myometrial cell into a leiomyoma cell remain(s) to be determined. Epidemiological studies have confirmed that different ethnic groups develop leiomyomas. However, African-American ethnicity is a risk factor for the development of leiomyomas. Studies have examined diet, genetics, hormonal, growth, enzymatic and molecular determinants of myoma biology, with critical advances in some of these areas. The best radiological tools to identify and monitor leiomyomas are ultrasonography and/or magnetic resonance imaging. Evidence supports progesterone and growth factors (e.g., transforming growth factor-B), have significant impact on the development of leiomyomas.


CONCLUSIONS
Early monitoring and intervention should become standard for African-American women who are at greater risk for developing leiomyomas. There are plausible biological mechanisms that explain the predisposition for developing larger leiomyomas in African-American women as compared with other ethnic groups.
Blake
Richard Enrique
RE
Department of Obstetric and Gynecology, Howard University College of Medicine, Washington, DC, USA. rblake@howard.edu
D018450:Disease Progression; D004958:Estradiol / Q000378:metabolism*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000208:ethnology / Q000378:metabolism / Q000473:pathology; D009367:Neoplasm Staging; D015995:Prevalence; D011372:Progestins / Q000378:metabolism*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000208:ethnology / Q000378:metabolism / Q000473:pathology; D016387:Women's Health
D011372:Progestins; D004958:Estradiol