Table 1.
Clinical profiles of women with different uterine leiomyomas.
Fig 1.
(A) Immunohistochemical staining of estrogen receptor (ER) and progesterone receptor (PR) in smooth muscle cells (SMCs) detected in biopsy samples derived from myoma (upper row) and adjacent myometria (lower row) of women with submucosal myoma (left panel), intramural myoma (middle panel) and subserosal myoma (right panel). (B) Shows number of estrogen receptor (ER, white box)- and progesterone receptor (PR, hatched box)-immunostained cells in myoma and myometria derived from these three groups of women. Scale bar = 50μm and 100μm for slides of (A). Comparing to ER, PR expression was significantly higher in fibroid tissue derived from women with subserosal myoma (p = 0.01). The boxes represent the interquartile ranges and horizontal lines in the boxes represent median values. HPF, high power field (x200).
Fig 2.
(A) Immunohistochemical staining of estrogen receptor (ER) and progesterone receptor (PR) in vascular endothelial cells (VECs) detected in biopsy samples derived from myoma (upper row) and adjacent myometria (lower row) of women with submucosal myoma (left panel), intramural myoma (middle panel) and subserosal myoma (right panel). Scale bar = 50μm for each slide. (B) Shows number of estrogen receptor (ER, white box)- and progesterone receptor (PR, hatched box)-immunostained VECs within myoma and adjacent myometria derived from these three groups of women. There was no significant difference between ER-and PR-stained VECs in either myoma or myometria derived from three types of fibroids. The boxes represent the interquartile ranges and horizontal lines in the boxes represent median values. HPF, high power field (x200).
Fig 3.
(A) Shows the number of estrogen receptor (ER, white box) and progesterone receptor (PR, hatched box)-immunostained cells in the combined myoma and myometria derived from GnRHa-treated (GnRHa+) and GnRHa-untreated (GnRHa-) women with submucosal myoma (SMM), intramural myoma (IMM) and subserosal myoma (SMM). In GnRHa-unteated group, PR content was significantly higher than ER in women with SMM and SSM (p = 0.04 for both). *p = 0.001, GnRHa (+) vs. GnRHa(-) for PR in women with SMM; **p = 0.03, GnRHa (+) vs. GnRHa(-) for ER in women with IMM; ***p = 0.03, GnRHa (+) vs. GnRHa(-) for PR in women with SSM. (B) Shows the number of ER and PR-immunostained vascular endothelial cells in the combined myoma and myometria derived from GnRHa-treated (GnRHa+) and GnRHa-untreated (GnRHa-) women with SMM, IMM and SMM. *p = 0.002, GnRHa (+) vs. GnRHa(-) for ER in women with IMM. The boxes represent the interquartile ranges and horizontal lines in the boxes represent median values. HPF, high power field (x200).
Fig 4.
(A) Immunohistochemical staining of von Willebrand factor (VWF, middle slide) and gonadotropin-releasing hormone receptor (GnRHR, right slide) in vascular endothelial cells derived from human umbilical vein (HUVECs). The protein expression of GnRHR was detected in VWF-immunostained HUVECs. Non-immune IgG-stained HUVECs is shown as a negative control (left slide). (B) Effect of gonadotropin-releasing hormone agonist (GnRHa, leuprolide acetate) on BrdU incorporation into HUVECs. Both GnRHa-treated and non-treated cells were incubated for 48h. Results are expressed as the mean percentages of the untreated cells (± SEM) of triplicate experiments using cells derived from HUVECs. *p<0.05 for each indicated dose (10-8M to 10-5M) of GnRHa-treated versus -untreated cells.
Fig 5.
(A) Masson’s trichrome (MT)-stained fibrosis in the biopsy samples derived from myoma (upper row) and myometria (lower row) of women with submucosal myoma (SMM, left column), intramural myoma (middle column) and subserosal myoma (SSM, right column) regardless of GnRHa treatment. Scale bar = 50μm for each slide. (B) Computer-captured image analysis of fibrosis indicated that comparing to myoma (white box), percentage of fibrosis was significantly higher in myometrium (hatched box) derived from women with IMM (p = 0.04). There was no significant difference in the percentage of fibrosis between myoma and myometria derived from women with SMM and SSM. The boxes represent the interquartile ranges and horizontal lines in the boxes represent median values.
Fig 6.
(A) Masson’s trichrome (MT)-stained fibrosis in the biopsy samples derived from myoma (upper row) and myometria (lower row) of GnRHa-treated (GnRHa+, hatched box) and GnRHa-untreated (GnRHa-, white box) women with submucosal myoma (SMM, left column), intramural myoma (IMM, middle column) and subserosal myoma (SSM, right column). Scale bar = 50μm for each slide. (B) Computer-captured image analysis of fibrosis in combined myoma and myometria indicated that there was no significant difference in the percentage of fibrosis between GnRHa (-) and GnRHa (+) group of women with SMM, IMM and SSM. The boxes represent the interquartile ranges and horizontal lines in the boxes represent median values.
Fig 7.
The distribution of Masson’s trichrome (MT)-stained perivascular fibrosis in the biopsy samples derived from myoma (upper row) and myometria (lower row) of women with submucosal myoma (SMM, left column), intramural myoma (IMM, middle column) and subserosal myoma (SSM, right column).
A variable distribution of dense fibrosis was observed around the small size and large size vessels in the myoma and myometria derived from women with SMM, IMM and SSM. Scale bar = 50μm for each slide.
Fig 8.
(A) Computer-captured image analysis of fibrosis in the biopsy specimens derived from combined myoma and myometria of women with different types of uterine myoma based on age of the patients. The percentage of fibrosis in their 30th, 40th and 50th years appears to be higher comparing to women in their 10th and 20th years of age. (B). Analysis of fibrosis in similar biopsy specimens demonstrated a size-dependent increase in the percentage of fibrosis in women with combined SMM, IMM and SSM. Kruskal-Wallis test indicated the higher percentage of fibrosis in myoma/myometria with increasing size (4.1-5cm, 6.1–7.0cm and >10cm) comparing to those with other sizes of myoma. The results are expressed as mean ± SEM.