Abstract
Objects: To investigate the pathogenesis of amyloid presented in uterine leiomyoma. Methods: 36 uterine leiomyoma patients were recruited and divided into two groups according to Congo red staining results. 6 cases are Congo red staining-positive, and 30 cases Congo red staining-negative which represented amyloid positive and amyloid negative respectively. All patients’ serum total protein (TP), albumin (Alb) and prealbumin (PA) levels were measured as well as blood hemoglobin (Hb), cell counts of white blood cell (WBC), neutrophils (NEU) and lymphocyte (LYM). Glycogen in tissue was compared between amyloid accumulated and amyloid negative sections with periodic acid schiff staining (PAS) in leiomyoma patients. Results: All of blood Hb concentration, WBC, NEU and LYM have not been found significant differences between two groups. Also no obvious infiltration of inflammatory cells was observed in tissue with amyloid deposition in uterine leiomyoma patients. And levels of TP, Alb and prealbumin have not been found significant differences between two groups. The amyloid was negative in leiomyoma entity cells range by Congo red staining, while small blood vessels in myoma tissues were positively detected with high rate. Amyloid was found in normal tissue around myoma as well as in blood vessel of pseudo-capsule. Increased PAS-positive material induced by leiomyoma was not correlated with amyloid deposition. Conclusions: Metabolic changes in the setting of functional alterations of cell in local microenvironment with uterine leiomyoma, may be related to the amyloid deposition.
Highlights
Uterine leiomyoma is the most common benign tumor of female genital mutilation, mainly found in 30 - 50 year-old women, of which morbidity reaches 20% - 30% [1]
Indicators reflecting the anemia and infection through blood routine examination between leiomyoma patients with positive and negative amyloid deposition: there was no significant difference of Hb between two groups (P = 0.505, >0.05); no significant differences of white blood cells and absolute neutrophil count was seen between two groups, neither absolute lymphocyte count was (Table 1)
Under light microscopy inflammatory cell infiltration was rarely observed around CR positive smooth muscle fiber or in CR positive arterioles wall and inflammatory cell number was not significantly different in these areas compared with CR negative tissue (Figure 1)
Summary
Uterine leiomyoma is the most common benign tumor of female genital mutilation, mainly found in 30 - 50 year-old women, of which morbidity reaches 20% - 30% [1]. The pathogenesis of uterine leiomyoma is still unclear, but evidence suggests that growth of cells is tied to estrogen e.g. overexpression of mRNA of progesterone receptor in the surface of uterine leiomyoma revealed an activated phenotype of progestational proliferation, plausibly related to the growth of uterine leiomyoma [2]. Uterine leiomyoma cells have a significantly higher response to estrogen than do matched myometrial culture [3]. R., et al [4] found that extracellular matrix (ECM) including collagen and glycosaminoglycan were highly expressed in leiomyoma which was associated with increased stiffness of leiomyoma. What’s more, ECM alteration was accompanied with hyaluronic acid and sulfuric acid decreased but keratan sulfate and dermatan sulfate significantly increased [5]
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