Fibroid Growth Study

在纤维瘤生长研究(FGS)中，我们收集了各种数据，例如随着时间的推移(最多4个时间点)纤维瘤体积的MRI测量，从选择手术的女性获得的肿瘤基因表达微阵列数据等。 作为我们最近发表的论文(Peddada等人，PNAS，2008)的后续，在这个项目中，我们使用101个肌瘤样本评估了短期生长激增和肌瘤生长速度的变化，这些样本在登记时、3、6和12个月进行了测量。如果(I)肌瘤体积每3个月至少以30%的速度增加，并且(Ii)该速度与其他两个时间间隔中的每个时间间隔的生长速度之间的差异至少为30%，则称肌瘤在特定时间间隔内经历生长激增。例如，假设肌瘤在三个时间间隔内以45%、25%和7%的速度(每3个月)生长。那么这个肌瘤满足(I)，但不满足(II)，因此，根据我们的定义，它没有经历生长激增。然而，生长速度为1%、35%、2%的肌瘤在第二个时间间隔内经历了生长激增。在101个肌瘤中有37个观察到生长激增，患病率比潜在的测量误差高出近10倍。 通过计算三个区间特定生长率的方差，获得每个肌瘤生长率短期变化的总体测量。有趣的是，同一名女性体内的肌瘤在其生长速度的短期变化上存在显著差异。女性特有的因素，如年龄、种族/民族、产次、体重或子宫肌瘤的位置，都不能解释同一女性子宫肌瘤之间的差异。然而，较大的肌瘤(直径5厘米)相对生长率的短期变化要比较小的肌瘤小。这些发现可能具有临床意义。

In the Fibroid Growth Study(FGS) we collected a variety of data, such as MRI measurements of fibroid volumes over time (up to 4 time points), gene expression microarray data obtained on tumors from women who opted for surgery, etc. We are presently analyzing data obtained from that study. As a follow-up to our recent publication (Peddada et al., PNAS, 2008), in this project we evaluated the short term growth spurts and changes in growth rates of fibroids using a sample of 101 fibroids that were measured at enrollment, 3, 6, and 12 months. A fibroid is said to experience a growth spurt in a particular time interval if (i) its volume increased at a rate of at least 30% per 3 months during that interval and (ii) the difference between that rate and the growth rate in each of the other two intervals is at least 30%. For example, suppose a fibroid grew at the rates of 45%, 25% and 7% (per 3 months) in the three time intervals. Then this fibroid satisfies (i) but not (ii) and hence according to our definition it did not experience a growth spurt. However, a fibroid with growth rates 1%, 35%, 2% experienced a growth spurt in the second time interval. Growth spurts were observed in 37 of the 101 fibroids, a prevalence nearly tenfold higher than that attributable to potential measurement error. An overall measure of short-term change in growth rate for each fibroid was obtained by calculating the variance of the three interval-specific growth rates. Interestingly, fibroids within the same woman varied significantly in their short-term change in growth rate. Neither the woman-specific factors, such as, age, race/ethnicity, parity, body mass, nor the fibroid position in the uterus explained the differences among fibroids within the same woman. However, large fibroids (>5 cm diameter) had a smaller short-term change in relative growth rate than smaller fibroids. These findings may be clinically relevant.