RESUMO
Uterine leiomyomas (ULs) are benign monoclonal tumors that arise from the underlying myometrial tissue in the uterus. Effective therapies are still lacking because of poor understanding of the pathophysiology and epidemiology. Hence, it is urgent to establish efficient animal models to screen novel anti-UL therapies. In this study, for the first time, traditional Chinese medicine and Western medicine were combined to establish an animal model of ULs in rats. In order to evaluate the function and value of the novel model, it was compared with other models. The long-term and short-term rat models for ULs were established using progesterone and diethylstilbestrol. Rats in Qi stagnation and blood stasis group were injected with epinephrine hydrochloride and received chronic unpredictable stress for two weeks. Rats in combining disease with syndrome group (CDWSG) received not only epinephrine hydrochloride injection and chronic unpredictable stress but also progesterone and diethylstilbestrol treatment. We analyzed differences in organ coefficient, uterus size, uterine pathology, concentrations of progesterone, estradiol, progesterone receptor, estrogen receptor, expression of desmin, α-smooth muscle actin, and vimentin among the five groups. The animal model of ULs was successfully constructed by loading the rats with estrogen and progesterone. The rat model of CDWSG was more stable than other groups and the method was the most efficient.
Assuntos
Modelos Animais de Doenças , Leiomioma/induzido quimicamente , Medicina Tradicional Chinesa , Neoplasias Uterinas/induzido quimicamente , Animais , Dietilestilbestrol/administração & dosagem , Ensaio de Imunoadsorção Enzimática , Epinefrina/administração & dosagem , Feminino , Imuno-Histoquímica , Progesterona/administração & dosagem , Ratos , Ratos Sprague-DawleyRESUMO
Uterine leiomyomas (ULs) are benign monoclonal tumors that arise from the underlying myometrial tissue in the uterus. Effective therapies are still lacking because of poor understanding of the pathophysiology and epidemiology. Hence, it is urgent to establish efficient animal models to screen novel anti-UL therapies. In this study, for the first time, traditional Chinese medicine and Western medicine were combined to establish an animal model of ULs in rats. In order to evaluate the function and value of the novel model, it was compared with other models. The long-term and short-term rat models for ULs were established using progesterone and diethylstilbestrol. Rats in Qi stagnation and blood stasis group were injected with epinephrine hydrochloride and received chronic unpredictable stress for two weeks. Rats in combining disease with syndrome group (CDWSG) received not only epinephrine hydrochloride injection and chronic unpredictable stress but also progesterone and diethylstilbestrol treatment. We analyzed differences in organ coefficient, uterus size, uterine pathology, concentrations of progesterone, estradiol, progesterone receptor, estrogen receptor, expression of desmin, α-smooth muscle actin, and vimentin among the five groups. The animal model of ULs was successfully constructed by loading the rats with estrogen and progesterone. The rat model of CDWSG was more stable than other groups and the method was the most efficient.
Assuntos
Animais , Feminino , Ratos , Neoplasias Uterinas/induzido quimicamente , Modelos Animais de Doenças , Leiomioma/induzido quimicamente , Medicina Tradicional Chinesa , Progesterona/administração & dosagem , Ensaio de Imunoadsorção Enzimática , Imuno-Histoquímica , Epinefrina/administração & dosagem , Ratos Sprague-Dawley , Dietilestilbestrol/administração & dosagemRESUMO
BACKGROUND: Uterine leiomyomata (fibroids) are hormonally responsive tumors, but little is known about risk factors. Early-life exposures may influence uterine development and subsequent response to hormones in adulthood. An earlier analysis of non-Hispanic white women who participated in the Sister Study found associations between several early-life factors and early-onset fibroids. OBJECTIVES: We evaluated associations of early-life and childhood exposures with early-onset fibroids among black women and compared the results with those found among white women. METHODS: We analyzed baseline data from 3,534 black women, 35-59 years of age, in the Sister Study (a nationwide cohort of women who had a sister diagnosed with breast cancer) who self-reported information on early-life and childhood exposures. Early-onset fibroids were assessed based on self-report of a physician diagnosis of fibroids by the age of 30 years (n = 561). We estimated risk ratios (RR) and 95% confidence intervals (CI) from log-binomial regression models. RESULTS: Factors most strongly associated with early-onset fibroids were in utero diethylstilbestrol (DES; RR = 2.02; 95% CI: 1.28, 3.18), maternal prepregnancy diabetes or gestational diabetes (RR = 1.54; 95% CI: 0.95, 2.49), and monozygotic multiple birth (RR = 1.94; 95% CI: 1.26, 2.99). We also found positive associations with having been taller or thinner than peers at the age of 10 years and with early-life factors that included being the firstborn child of a teenage mother, maternal hypertensive disorder, preterm birth, and having been fed soy formula. CONCLUSIONS: With the exception of monozygotic multiple birth and maternal hypertensive disorder, early-life risk factors for early-onset fibroids for black women were similar to those found for white women. However, in contrast to whites, childhood height and weight, but not low socioeconomic status indicators, were associated with early-onset fibroids in blacks. The general consistency of early-life findings for black and white women supports a possible role of early-life factors in fibroid development.
Assuntos
Leiomioma/induzido quimicamente , Leiomioma/etnologia , Exposição Materna , Efeitos Tardios da Exposição Pré-Natal/etnologia , Neoplasias Uterinas/induzido quimicamente , Neoplasias Uterinas/etnologia , Adulto , Negro ou Afro-Americano , Estudos de Coortes , Feminino , Humanos , Leiomioma/diagnóstico , Leiomioma/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Estudos Prospectivos , Porto Rico/epidemiologia , Fatores de Risco , Irmãos , Fatores de Tempo , Estados Unidos/epidemiologia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/epidemiologiaAssuntos
Clordecona/efeitos adversos , Inseticidas/efeitos adversos , Neoplasias/induzido quimicamente , Neoplasias/epidemiologia , Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/epidemiologia , Feminino , Guadalupe/epidemiologia , Humanos , Incidência , Masculino , Martinica/epidemiologia , Neoplasias da Próstata/induzido quimicamente , Neoplasias da Próstata/epidemiologia , Neoplasias Gástricas/induzido quimicamente , Neoplasias Gástricas/epidemiologia , Neoplasias Uterinas/induzido quimicamente , Neoplasias Uterinas/epidemiologia , Índias Ocidentais/epidemiologiaAssuntos
Estrogênios/efeitos adversos , Ginecologia/história , Progesterona/uso terapêutico , Neoplasias do Colo do Útero , Neoplasias Uterinas , Feminino , História do Século XX , Humanos , Neoplasias do Colo do Útero/induzido quimicamente , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias Uterinas/induzido quimicamente , Neoplasias Uterinas/patologia , Neoplasias Uterinas/prevenção & controleRESUMO
OBJECTIVE: Controversy exists regarding the use of oral contraceptives following hydatidiform mole and possible increased risk of persistent trophoblastic neoplasia. The purpose of this study is to perform a systematic review of the literature to assess the evidence for and against a possible link between oral contraceptive use and the need for chemotherapy after molar evacuation. METHODS: We searched the computerized databases MEDLINE, EMBASE, Popline, Web of Sciences, LILACS and the Cochrane Controlled Trials Register, ISI Proceedings, performed a hand search of references and wrote to experts to identify randomized controlled trials and observational studies comparing oral contraceptives with other methods of contraception. Quality assessment included: concealment of allocation; intention to treat analysis; plus attrition bias for trials; confounding factors and selection bias for observational studies. We collected or calculated risk ratios for the incidence of gestational trophoblastic neoplasia and hCG regression time associated with oral contraceptive use. RESULTS: Two randomized controlled trials were included for analysis. The risk ratios for OC use were similar in both studies: 0.69 (0.12-3.98) and 0.71 (0.46-1.10) respectively. No attempt to summarize these results was made because the studies observed different disease stages. In five of the seven observational studies, the risk ratio ranged from 0.57 (CI = 0.14-2.37) to 1.46 (CI = 0.56-3.79). CONCLUSION: No clear evidence for an association between oral contraceptive use during post-molar follow-up period and the incidence of gestational trophoblastic neoplasia was found. Practitioners should no longer avoid their use because of a supposed effect which we have shown here to be unsupported by evidence in the literature.
Assuntos
Anticoncepcionais Orais/efeitos adversos , Doença Trofoblástica Gestacional/induzido quimicamente , Neoplasias Uterinas/induzido quimicamente , Gonadotropina Coriônica Humana Subunidade beta/sangue , Terapia Combinada , Feminino , Doença Trofoblástica Gestacional/sangue , Humanos , Mola Hidatiforme/tratamento farmacológico , Mola Hidatiforme/cirurgia , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Uterinas/sangueRESUMO
Müllerian adenosarcoma with sarcomatous overgrowth presented by a 52-year-old female patient after adjuvant tamoxifen treatment for breast carcinoma is described. The diagnosis was made on histological basis after curettage and complementary total hysterectomy with bilateral salpingo-oophorectomy. The immunohistochemical study showed high expression of estrogen receptors in the epithelial component of the lesion and irregularly positive findings in the stroma. The proliferative activity evaluated by Ki-67 immunoexpression was higher in the stroma than the epithelium. Some of the stromal cells showed rhabdomyoblastic differentiation. The association of tamoxifen use and development of mesenchymal neoplasms is discussed.
Assuntos
Adenossarcoma/induzido quimicamente , Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Tamoxifeno/efeitos adversos , Neoplasias Uterinas/induzido quimicamente , Adenossarcoma/patologia , Neoplasias do Endométrio/induzido quimicamente , Neoplasias do Endométrio/patologia , Endométrio/patologia , Feminino , Humanos , Histerectomia , Imuno-Histoquímica , Pessoa de Meia-Idade , Neoplasias Uterinas/patologiaRESUMO
Müllerian adenosarcoma with sarcomatous overgrowth presented by a 52-year-old female patient after adjuvant tamoxifen treatment for breast carcinoma is described. The diagnosis was made on histological basis after curettage and complementary total hysterectomy with bilateral salpingo-oophorectomy. The immunohistochemical study showed high expression of estrogen receptors in the epithelial component of the lesion and irregularly positive findings in the stroma. The proliferative activity evaluated by Ki-67 immunoexpression was higher in the stroma than the epithelium. Some of the stromal cells showed rhabdomyoblastic differentiation. The association of tamoxifen use and development of mesenchymal neoplasms is discussed.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Adenossarcoma/induzido quimicamente , Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Tamoxifeno/efeitos adversos , Neoplasias Uterinas/induzido quimicamente , Adenossarcoma/patologia , Neoplasias do Endométrio/induzido quimicamente , Neoplasias do Endométrio/patologia , Endométrio/patologia , Histerectomia , Imuno-Histoquímica , Neoplasias Uterinas/patologiaRESUMO
The authors refer to a 21-year-old Caucasian (white) woman, who in 1977 presented fever and cervical and axillary adenopathy, whose biopsy showed nodular sclerosis Hodgkin's Disease, stage IIIB. The patient received six chemotherapy cycles associated with immunotherapy and supplemented with radiation therapy with good response. RESULTS--In 1985, after routine gynaecological examination and a hysterectomy, cervical intraepithelial neoplasia grade 3 (CIN 3) and atypic leiomyoma of the uterine body were diagnosed. Five years later, biopsies diagnosed invasive duct carcinoma in the right breast and homolateral axillary and cervical nodes. The patient was submitted to chemo and radiation therapy and died nine months later. CONCLUSION--The possibility of later occurrence of a second or multiple new malignancies in patients successfully treated for Hodgkin's Disease points out the need for a more complete long-term follow-up, including periodic mammography.