Effect of gonadotropin-releasing hormone agonist treatment upon angiogenesis in uterine leiomyoma

Objective: To assess the effect of gonadotropin-releasing hormone (GnRH)ago nist treatment upon angiogenesis in uterine leiomyomata. Methods: Uterine l eiomyomata specimens of 49 consecutive patients who underwent myomectomy or hysterectomy following presurgical treatment with (n = 23) and without (n = 26) GnRH agonist were stained immunohistochemically with antibody to fact or VIII-related antigen. For each subject, age, parity, number of Lupron tr eatments, leiomyoma size (cm), and mean microvessel counts calculated from three fields (x400) were recorded. Differences in patient age, parity, micr ovessel counts and leiomyoma size between GnRH agonist treated and untreate d patients were tested by unpaired Student's t test. Differences among the various number of doses were tested by one-way ANOVA, with Bonferonni and N euman-Keuls post hoc tests between specific dose-number groups. The relatio nship between microvessel counts and leiomyoma size was tested by Pearson c orrelation test. Multivariate stepwise regression tested the relationship b etween the number of Lupron doses and microvessel counts, correcting for ag e, parity, and leiomyoma size. p < 0.05 was considered significant. Results : Patient age and parity were similar in GnRH treated and untreated patient s (mean 43.3 <plus/minus> 6.6 versus 43.9 +/- 7.5 years and median 2 (range 0-7) versus 1 (range 0-5), p = 0.78 and p = 0.45, respectively). Microvess el counts of leiomyomata specimens treated presurgically with GnRH agonist therapy (median 22.7, range 6.7-65.7) were not significantly different from microvessel counts of specimens without presurgical GnRH agonist treatment (median 19.8, range 6-53; p = 0.77). No correlation between leiomyoma size and microvessel counts was noted (r = 0.06, P = 0.7). Conclusion: Angiogen esis as assessed by microvessel counts in surgically removed leiomyomata is not affected by presurgical medical management with GnRH agonist therapy. Copyright (C) 2001 S. Karger AG, Basel.