Abstract
Uterine fibroids are one of the most common and yet understudied diseases in women mainly during their reproductive years. The study analyzed the efficacy and safety of oral administration of mifepristone combined with ultrasound-guided radiofrequency ablation in treating patients with uterine fibroids, as well as changes of inflammatory cytokines including procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor-alpha (TNF-α), adhesion molecules including monocyte chemotactic protein 1 (MCP-1) and soluble intercellular adhesion molecule 1 (sICAM-1), and growth factors including vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), transforming growth factor-β (TGF-β), and TGF-β receptor. A total of 130 patients who were admitted into our hospital for uterine fibroids from December 2016 to June 2018 were included, among which 65 women were given ultrasound-guided radiofrequency ablation alone (control group) and the remaining women were given oral administration of mifepristone combined with ultrasound-guided radiofrequency ablation (experimental group). Reduced volumes of uterus and fibroids were observed in both two groups after treatment ( P < 0.05 ). It was found that the experimental group exhibited higher total effective rate and smaller volumes of uterus and fibroids than the control group ( P < 0.05 ). Following treatment, the levels of MCP-1, sICAM-1, VEGF, EGF, bFGF, TGF-β, TGF-β receptor, PCT, hs-CRP, and TNF-α in the serum in the two groups were declined ( P < 0.05 ), while this decline was more significantly in the experimental group than the control group ( P < 0.05 ). Besides, there was no significant difference in the incidence rate of adverse reactions between the two groups ( χ 2 = 0.781 , P > 0.05 ). These results collectively indicate the high efficacy and safety of oral administration of mifepristone combined with ultrasound-guided radiofrequency ablation in treating patients with uterine fibroids, as this combination therapy could inhibit the expressions of inflammatory cytokines, adhesion molecules, and growth factors.
Highlights
Uterine fibroids are commonly seen in benign uterine tumors in fertile females, defined as fibroids or myomas [1, 2]
In this study, the changes of serum inflammatory cytokines including inflammatory cytokines including procalcitonin (PCT), high-sensitivity C-reactive protein, and tumor necrosis factor-alpha (TNF-α); adhesion molecules including monocyte chemotactic protein 1 (MCP-1) and soluble intercellular adhesion molecule 1; and growth factors including vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), basic fibroblast growth factor, transforming growth factor-β (TGFβ), and TGF-β receptor will be analyzed by mifepristone combined with ultrasound-guided radiofrequency ablation, in order to provide more reliable data for clinical management for uterine fibroid
We are interested in a hypothesis that MCP-1 and soluble intercellular adhesion molecule 1 (sICAM-1) expressions are altered in patients with uterine fibroids undergoing oral administration of mifepristone combined with ultrasound-guided radiofrequency ablation
Summary
Uterine fibroids are commonly seen in benign uterine tumors in fertile females, defined as fibroids or myomas [1, 2]. Except for medication interruption, ultrasound-guided radiofrequency ablation (RFA) was performed in a minimally invasive manner, which is widely accepted as a reliable and effective treatment. It can induce coagulation necrosis by entering uterine fibroids through laparoscopy, vagina, or cervix [13]. Adhesion molecules play crucial roles in cell recognition, cell activation and signal transduction, cell proliferation and differentiation, and cell motility They are engaged in various biological processes, such as immune response, inflammation, coagulation, tumor metastasis, and wound healing [14, 15]. In this study, the changes of serum inflammatory cytokines including inflammatory cytokines including procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor-alpha (TNF-α); adhesion molecules including monocyte chemotactic protein 1 (MCP-1) and soluble intercellular adhesion molecule 1 (sICAM-1); and growth factors including vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), transforming growth factor-β (TGFβ), and TGF-β receptor will be analyzed by mifepristone combined with ultrasound-guided radiofrequency ablation, in order to provide more reliable data for clinical management for uterine fibroid
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