Fibroid Growth Study

子宫平滑肌瘤，通常称为肌瘤，是育龄妇女的主要健康问题。本研究的目的是研究子宫平滑肌瘤在临床相关人群中的生长动态。本项目感兴趣的基本问题是验证子宫平滑肌瘤在其生长特征和临床症状或结果方面具有异质性的假设，以及平滑肌瘤生长动力学的差异可以通过分子标记和细胞表型来区分。研究对象为115例至少有1个子宫平滑肌瘤的绝经前妇女（年龄在18岁至18岁之间）。患者入组的入选标准为超声确诊的平滑肌瘤。至少有一个平滑肌瘤的直径必须大于或等于2厘米，或者子宫必须扩大到怀孕第八周时的典型大小（表明存在许多平滑肌瘤）。入组并获得知情同意后，在第一次就诊时进行T1和t2加权磁共振成像（MRI）扫描，然后在第3、6和12个月进行扫描。每位患者在每次核磁共振检查时都进行了身体检查，并提供了尿液和血液样本，并回答了最初广泛的电话问卷调查，随后每月更新简短的问卷调查。其中，28名妇女需要手术干预（子宫切除术/子宫肌瘤切除术）。对这些妇女的平滑肌瘤样本进行了与生长相关的组织病理学和分子变化分析。该研究的具体目的是：(1)研究平滑肌瘤的生长与多样性和位置的关系；(2)检查平滑肌瘤生长与临床症状或转归的关系；(3)鉴别具有不同生长动力学的平滑肌瘤的分子、细胞和病理特征；(4)探讨与子宫平滑肌瘤差异生长动力学相关的内分泌参数和生活方式因素。

Uterine leiomyomas, commonly called fibroids, are a major health concern for women of reproductive age. The objectives of the study described herein are to investigate the growth dynamics of uterine leiomyomas in a clinically relevant population of women. Basic questionsof interest in this project are test the hypotheses that uterine leiomyomas are heterogeneous in terms of their growth characteristics and in their clinical symptoms or outcomes, and that differences in leiomyoma growth dynamics can be discriminated by molecular markers and cellular phenotypes. Study included about 115 premenopausal women (>18 years old) with at least one uterine leiomyoma. The inclusion criteria for patient enrollment is confirmed diagnosis of leiomyoma by ultrasound. At least one leiomyoma must be equal to or greater than 2 cm in diameter or the uterus must be enlarged to the size typical during the eighth week of pregnancy (indicating many leiomyomas are present). After enrollment and informed consent, T1- and T2-weighted magnetic resonance image (MRI) scans were conducted beginning at the first visit and then at 3, 6, and 12 months. Each patient had a physical exam and provided urine and blood samples at each MRI visit, and responded to an initial extensive telephone-administered questionnaire followed by abbreviated monthly questionnaire updates. Of these, 28 women required surgical intervention (hysterectomy/ myomectomy). Leiomyoma samples from these women were analyzed for histopathological and molecular changes correlated with growth. The specific aims of the study are to: (1) investigate leiomyoma growth as a function of multiplicity and location; (2) examine the relationship between leiomyoma growth and clinical symptoms or outcome; (3) identify molecular, cellular, and pathological characteristics of leiomyomas with differing growth dynamics; and (4) examine endocrinological parameters and lifestyle factors related to differential growth dynamics of uterine leiomyomas.