EPIDEMIOLOGICAL AND FAMILIAL RISK FACTORS OF UTERINE LEIOMYOMA DEVELOPMENT, ACTA UNIVERSITATIS OULUENSIS D Medica 1407
|Kustantaja:||Oulun yliopisto|| |
|Painos:||Osajulkaisuväitöskirjan yhteenveto-osa|| |
|Sijainti:||Print Tietotalo|| |
|Tekijät:||UIMARI OUTI|| |
Uterine leiomyomas are the most common benign tumours in females. They are myometrial
neoplasms, may present single or multiple, and may be located in various sites of the uterus.
Leiomyomas distort the uterine cavity and the uterus itself, causing abnormal vaginal bleeding,
reduced fertility and also pelvic pressure and pain symptoms. The aim of this study was to
elaborate current knowledge on familial uterine leiomyomas and to explore the possible
association between uterine leiomyoma and cardiovascular disease risk factors, and also the
association between leiomyomas and endometriosis.
The natural history of familial uterine leiomyoma study showed significant differences
between familial and non-familial leiomyoma cases, familial cases having more severe clinical
characteristics. They presented with multiple uterine leiomyomas and were more often
symptomatic. They were also diagnosed at a younger age.
The prevalence study on uterine leiomyomas and endometriosis offered confirmation of an
association between the diseases. Uterine leiomyomas and endometriosis seem to decrease female
fertility independently of each other.
Uterine leiomyomas related to the hereditary leiomyomatosis and renal cell cancer (HLRCC)
tumour syndrome were studied in regard to their clinical characteristics and immunophenotype.
The study provided evidence that women with HLRCC may be identified through distinct
leiomyoma clinical characteristics, and routine-use IHC of CD34 and Bcl-2. Distinguishing these
leiomyoma cases from sporadic ones may identify families affected by fumarate hydratase
(fumarase, FH) mutation.
Uterine leiomyoma and cardiovascular disease risk factors were studied in The Northern
Finland Birth Cohort 1966 (NFBC1966). The study showed an association between leiomyomas
and raised cardiovascular disease risk factors, serum lipids and metabolic syndrome in particular.
These findings may suggest that there are shared predisposing factors underlying both uterine
leiomyomas and adverse metabolic and cardiac disease risks, or that metabolic factors have a role
in biological mechanisms underlying leiomyoma development.
This study provides novel information on clinical characteristics of familial uterine
leiomyomas and on the immunophenotype of HLRCC-related leiomyomas. The study also offers
significant confirmation of associations between uterine leiomyomas and both endometriosis and
several CVD risk factors.