ESTROGEN AND PROGESTERONE-RECEPTOR CONTENT OF ENUCLEATED UTERINE MYOMATA AFTER LUTEINIZING-HORMONE-RELEASING HORMONE - ANALOG DEPOT THERAPY

We wanted to correlate the degree of myoma shrinkage after luteinizing hormone-releasing hormone (LHRH)-analogue depot therapy to the estrogen and progesterone receptor content of the enucleated fibroids. Twenty premenopausal, regularly menstruating women wishing to preserve their childbearing capacity were treated for three to six months with 3.75 mg of leuprorelin acetate depot subcutaneously. Four weeks after the last injection, all fibroids were enucleated and investigated immunohistochemically by using monoclonal (rat) antibodies to human estrogen and progesterone receptors. The localization and distribution of nuclear staining was visualized through a light microscope and scored semiquantitatively by multiplying the staining intensity with the percentage of positive cells. Although LHRH-analogue depot therapy led to almost the same degree of ovarian suppression in all of the women, extent of myoma shrinkage varied from O% to 87%. On the other hand the extent of myoma regression correlated significantly to the estrogen receptor content of the enucleated fibroid, while diminution of myoma size seemed to be independent of the progesterone receptor. This indicates an association between myoma shrinkage and the estrogen receptor status of the enucleated fibroid. It remains to be proved that pretreatment receptor analysis may predict the myomata that are sensitive to endocrine treatment.