Clinical significance of oestrogen and progesterone receptors in the growth and symptomatology of uterine fibroids
Background: Uterine fibroids are responsible for significant morbidity in a large proportion of the female population of the reproductive age worldwide. Hence, there is a need to determine the levels of oestrogen and progesterone receptors in relation to the growth and symptomatology in a purely African population noted for high incidence of uterine fibroids.
Objectives: To determine the levels of oestrogen and progesterone receptors in normal myometrium and uterine fibroids and ascertain whether there are any significant clinical associations.
Materials and Methods: This was a prospective study conducted at the Obstetrics and Gynaecology Department in collaboration with the Morbid Anatomy Department, both at the University of Benin Teaching Hospital (UBTH). Tissue specimens obtained from uterine fibroids and normal myometrium during surgeries performed on patients with a pre‑operative diagnosis of uterine fibroids were histologically examined. The concentrations of oestrogen and progesterone receptors were histochemically determined for the selective tissue slides. The results and the socio‑demographic characteristics of the patients were used to generate a database for analysis.
Results: A total of 262 cases of uterine fibroids were analysed. Those presenting with lower abdominal mass had more oestrogen receptors in uterine fibroids (57.0%, P = 0.014), whereas more progesterone receptors were found in those presenting with menorrhagia (P = 0.001). A comparison of oestrogen and progesterone receptors in uterine fibroids and normal myometrium showed significantly higher levels of oestrogen and progesterone receptors in fibroids than in normal myometrium (P = 0.000).
Conclusion: The concentrations of oestrogen and progesterone receptors in uterine fibroids were significantly higher than those in normal myometrium. The steroid dependence of the growth and symptomatology of uterine fibroids may be related to the steroid receptor level. Identification and quantification of the concentrations of oestrogen and progesterone receptors will be useful in the prognostication and the development of newer treatment modalities for uterine fibroids. Further research in this area is clearly warranted.
Key words: Myometrial tissues; oestrogen receptors; progesterone receptors; uterine fibroids; University of Benin Teaching Hospital.