Expression profile of the tumorigenic factors associated with tumor size and sex steroid hormone status in uterine leiomyomata

Objective: To use tissue microarray in combination with dendrogram cluster analysis to characterize some potential tumorigenic factors in association with tumor size and sex steroid hormone status in uterine leiomyomata. Design: Expression analysis of 21 selected potential tumorigenic factors in 60 patients with uterine leiomyomata. Setting: University clinical research laboratory. Patient(s): Hysterectomy specimens from 60 patients with uterine leiomyomata of different ages and tumor sizes. Intervention(s): Tissue cores from normal myometrium and leiomyomata were examined by immunohistochemistry. Main Outcome Measure(s): Semiquantitative immunointensity was scored and analyzed by net gain and loss between normal myometrium and leiomyomata and integrated into dendrogram cluster tree view. Result(s): We found that upregulation of estrogen and progesterone receptors was reverse associated with tumor size. Upregulation of some factors (HMGA2, sex steroid receptor cofactors, proteins in insulin pathway, and CD24) were identified in a group of patients in their later forties, were associated with large fibroids, and were weakly affected by the SSH status (illustrated by endometrial phases and menopause). Downregulation of tuberin and glucocorticoid receptor was mostly isolated in a second group of women at their late reproductive age. Conclusion(s): Analyses of the sex steroid hormone receptors and the nonsex steroid hormone factors in leiomyomata and the matched myometrium showed different expression patterns in different tumor sizes and patients' ages. A group of patients in their late forties with the larger leiomyomata contributes largely by upregulation of nonsex steroid hormone factors. Adenomyosis is a protective factor preventing large leiomyomata.