Clinical correlates of leiomyoma estrogen and progesterone receptors among Nigerian women.
OBJECTIVE
To compare the expression of estrogen receptor α (ERα) and progesterone receptor (PR) in myometrium and leiomyomata tissue, and to correlate their expression with symptoms of uterine leiomyomata.


METHODS
In a cross-sectional study, intraoperative biopsy samples of leiomyomata and adjacent myometrial specimens were obtained from premenopausal women with uterine leiomyomata treated at a center in Nigeria between September 2013 and August 2014. Immunohistochemistry for ERα and PR expression was performed on the samples. The immunoscores of both receptors were correlated with the size and symptoms of the leiomyomata.


RESULTS
Among 60 pairs of samples, leiomyomata had a higher mean expression of ERα (H-score 193.42±64.55 vs 153.29±69.13; P=0.01) and PR (214.86±66.56 vs 171.53±63.53; P<0.001) than did myometrial tissues. The tumor diameter correlated negatively with the immunoscores of both receptors irrespective of age, parity, and body mass index, but this was only significant for PR (ρ=-0.44; P<0.001). Downregulation of PR on leiomyomata was predicted to occur at a diameter of 11cm. Menorrhagia, dysmenorrhea, and infertility occurred independently of steroid-receptor expression.


CONCLUSIONS
Leiomyomata seem to depend on steroid hormones, but only during early tumor development. This could have implications for the selection of patients for medical management, especially with steroid-receptor modulators.
Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University, Ile-Ife, Nigeria; Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Electronic address: drawo2001@yahoo.com.
Ibraheem O
IO
Awowole
Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University, Ile-Ife, Nigeria; Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Olufemiwa N
ON
Makinde
Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University, Ile-Ife, Nigeria; Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Olusegun O
OO
Badejoko
Department of Morbid Anatomy and Cellular Histopathology, Obafemi Awolowo University, Ile-Ife, Nigeria.
Ganiyat O
GO
Omoniyi-Esan
Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology, Ogbomosho, Nigeria.
Aramide M
AM
Tijani
Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University, Ile-Ife, Nigeria; Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Kayode O
KO
Ajenifuja
Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University, Ile-Ife, Nigeria; Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Olabisi M
OM
Loto
D000328:Adult; D003430:Cross-Sectional Studies; D047628:Estrogen Receptor alpha / Q000378:metabolism*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology*; D009549:Nigeria; D017697:Premenopause / Q000502:physiology*; D011980:Receptors, Progesterone / Q000378:metabolism*; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery
C506487:ESR1 protein, human; D047628:Estrogen Receptor alpha; D011980:Receptors, Progesterone
Estrogen receptor; H-score; Immunohistochemistry; Leiomyoma; Progesterone receptor