Патоморфологические маркеры рецидивирующей лейомиомы матки в репродуктивном возрасте

Abstract

Aim. To determine the pathomorphological markers and clinical factors of recurrent uterine fibroids in reproductive age. Design. Prospective, non-randomized, longitudinal study. Materials and methods. The study included 75 patients, of whom 52 had uterine fibroids without recurrence (group I), 23 with relapse (group II). Indications for surgical treatment were: prolonged, heavy menstruation leading to anemia, pain syndrome, recurrent abnormal uterine bleeding, compression syndrome of adjacent organs. The study included patients with myomatous nodes of types 0–7 according to the FIGO (International Federation of Gynaecology and Obstetrics) classification. Results. During morphological examination, leiomyoma was macroscopically presented as a dense nodular formation with an uneven surface, whitish in color, and fibrous in appearance when cut. When comparing the size of the uterus (weeks of conditional pregnancy) in the comparison groups, it was revealed that in group I Me (Q1–Q2) was 13.00 (10.0–15.0), in group II - 13.0 (11.0–15.0) without statistically significant differences (p = 0.58). At the same time, in patients of group II with uterine sizes up to 10 weeks. – recurrence of uterine fibroids occurs in every fifth (21.7%), from 10 to 15 weeks. almost every second (60.9%) and more than 15 weeks. – every sixth (17.4%) (see diagram 1). As for the number of myomatous nodes, in group II, multiple uterine fibroids were detected in every second patient (60.9%). When comparing the growth rate of myomatous nodes in half (43.5%) of the examined women with relapse, their growth rate ranged from 6 months to 1 year, in every third (39.1%) — more than 1 year. Conclusion. According to our data, patients with recurrent uterine myoma have a number of clinical features compared to those with simple uterine myoma — younger age and duration of the disease. Recurrent uterine fibroids are characterized by rapid growth of myomatous nodes, large size and growth rate of nodes. Thus, understanding all of the mechanisms underlying leiomyoma through the integration of differential cellular/molecular characteristics may contribute to the discovery of tumor-specific biomarkers as well as the development of targeted therapeutic approaches that specifically target the affected pathways. Key words: uterine leyomioma, pathomorphology of uterine leyomioma, growth zones of leiomyoma.