title: Increased progesterone receptor expression in uterine leiomyoma: correlation with age, number of leiomyomas, and clinical symptoms.
abstract: OBJECTIVE
  To investigate the possible correlation between progesterone receptor (PR) expression in uterine leiomyoma or adjacent myometrium and patient's age, size/number of leiomyomas, or clinical symptoms such as dysmenorrhea, acyclic pelvic pain, or menstrual and intermenstrual uterine bleeding.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Referral center.
  
  
  METHODS
  Sixty-two Chinese women undergoing elective hysterectomy for uterine leiomyomata.
  
  
  METHODS
  None.
  
  
  METHODS
  Evaluation of PR-total and PR-B mRNA with real-time polymerase chain reaction; PR-A and PR-B proteins quantified by Western blot in leiomyoma tissue and myometrium; symptoms rated by the patients using visual analog scores.
  
  
  RESULTS
  The PR-B mRNA and PR-A and PR-B proteins were more concentrated in leiomyomas than in matched myometrium. A direct correlation between PR-B mRNA levels in leiomyoma and age (r = 0.347) and number of tumors (r = 0.295) was found. Conversely, there was an inverse correlation between PR-B mRNA levels in leiomyoma and dysmenorrhea (r = -0.260) and intermenstrual bleeding (r = -0.266). Multiple regression analysis indicated that age (β = 0.363) and the number of myomas (β = 0.296) were independently associated with PR-B mRNA levels in leiomyoma tissue.
  
  
  CONCLUSIONS
  The levels of PR-B mRNA in leiomyoma tissue are directly associated with the number of tumors and inversely correlated with the intensity of intermenstrual bleeding and dysmenorrhea, suggesting that PR signaling may favor leiomyoma growth while attenuating clinical symptoms. This duality should be taken into account in the clinical management of patients with symptomatic uterine leiomyoma.
authors.affiliation: Department of Biological Sciences, Xi'an Jiaotong Liverpool University, Suzhou, People's Republic of China.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Tsigkou
authors.affiliation: Division of Human Reproduction, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Reis
authors.affiliation: Department of Biological Sciences, Xi'an Jiaotong Liverpool University, Suzhou, People's Republic of China.
authors.forename: Meng H
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Guangzhou University, Panyu, People's Republic of China.
authors.forename: Bingjie
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Tosti
authors.affiliation: Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Centini
authors.affiliation: Department of Obstetrics and Gynecology, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
authors.forename: Fang-Rong
authors.initials: FR
authors.lastname: Shen
authors.affiliation: Department of Obstetrics and Gynecology, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
authors.forename: You-Guo
authors.initials: YG
authors.lastname: Chen
authors.affiliation: Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy. Electronic address: felice.petraglia@unisi.it.
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis* / Q000378:metabolism*; D008875:Middle Aged; D011980:Receptors, Progesterone / Q000096:biosynthesis*; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D055815:Young Adult
chemical_list: D011980:Receptors, Progesterone
keywords: Abnormal uterine bleeding; dysmenorrhea; myometrium; progesterone receptors; uterine leiomyoma