Biological characteristics related to treatment effects of the levonorgestrel-releasing intrauterine system on adenomyosis-associated dysmenorrhoea

IF 3.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Reproductive biomedicine online Pub Date : 2024-07-27 DOI:10.1016/j.rbmo.2024.104393
Qiutong Li , Yi Dai , Xiaoyan Li , Yushi Wu , Zhiyue Gu , Chenyu Zhang , Hailan Yan , Shiqing Lyu , Biyun Zhang , Jinghua Shi , Jinhua Leng
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Abstract

Research question

Are there correlations between the biological expression of steroid receptors and the extent of fibrosis in adenomyotic lesions, and the treatment effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) on alleviation of adenomyosis-associated dysmenorrhoea.

Design

In this retrospective cohort study, 125 women with adenomyosis who underwent hysterectomy were screened. Tissue samples were collected from 41 patients who had undergone LNG-IUS treatment prior to surgery, and these patients were further categorized into the treatment effective group (n = 18) and the treatment failure group (n = 23) according to their self-reported relief from dysmenorrhoea after 6 months of treatment. Oestrogen receptor-α (ER-α) and progesterone receptor expression, and the extent of fibrosis in the adenomyotic lesions were measured using immunohistochemistry and Masson's trichrome staining, respectively.

Results

Patients in the treatment failure group demonstrated lower expression of ER-α and progesterone receptors, and more pronounced fibrosis in the stroma of adenomyotic lesions compared with patients in the treatment effective group. In the glandular epithelium of lesions, ER-α expression was reduced significantly in the treatment failure group, whereas no notable difference in the expression of progesterone receptors was observed. Notably, the staining intensity of ER-α in the stroma of lesions was found to have the strongest positive correlation with the degree of symptom alleviation for dysmenorrhoea (r = 0.703, P < 0.001), with an area under the curve of 0.894 for prediction.

Conclusions

The reduced expression of steroid receptors in adenomyotic lesions, especially ER-α in the stroma, was associated with increased likelihood of treatment failure of LNG-IUS for alleviation of dysmenorrhoea.
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类固醇受体的表达水平和病变纤维化与左炔诺孕酮释放宫内系统对子宫腺肌症相关性痛经的不同治疗效果有关
研究问题类固醇受体的生物学表达和子宫腺肌症病变的纤维化程度与左炔诺孕酮释放宫内避孕系统(LNG-IUS)缓解子宫腺肌症相关痛经的治疗效果之间是否存在相关性。根据治疗 6 个月后痛经缓解的自我报告,这些患者被进一步分为治疗有效组(18 人)和治疗失败组(23 人)。结果与治疗有效组相比,治疗失败组患者的雌激素受体-α(ER-α)和孕酮受体表达较低,子宫腺肌症病灶基质的纤维化程度更明显。在病变的腺上皮中,治疗失败组的ER-α表达明显减少,而孕酮受体的表达则无明显差异。值得注意的是,病变基质中 ER-α 的染色强度与痛经症状缓解程度呈最强的正相关(r = 0.703,P < 0.001),预测曲线下面积为 0.894。结论子宫腺肌症病灶中类固醇受体表达的减少,尤其是基质中 ER-α 的减少,与 LNG-IUS 治疗痛经失败的可能性增加有关。
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来源期刊
Reproductive biomedicine online
Reproductive biomedicine online 医学-妇产科学
CiteScore
7.20
自引率
7.50%
发文量
391
审稿时长
50 days
期刊介绍: Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.
期刊最新文献
Ultra-fast vitrification and rapid elution of human oocytes: part I. germinal vesicle model validation. Ultra-fast vitrification and rapid elution of human oocytes: Part II - verification of blastocyst development from mature oocytes. Inside Front Cover - Affiliations and First page of TOC Front Matter - Continued TOC Outside Back Cover - Editorial Board
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