O. Abulafia et al., Effect of gonadotropin-releasing hormone agonist treatment upon angiogenesis in uterine leiomyoma, GYNECOL OBS, 52(2), 2001, pp. 108-113
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.