BONE AND MALIGNANT DISEASES OF UTERINE: PROFILE OF EXPRESSION OF GENES OF STEROID RECEPTORS AND TUMOR SUPPRESSOR PTEN

DOI: https://doi.org/10.29296/24999490-2018-03-08

L.G. Bazhenova(1), L.F. Gulyayeva(2), S.V. Shramko(1)
1-Novokuznetsk State Institute for Further Training of Physicians – Branch of the Russian Medical Academy
of Continuous Professional Education, Stroiteleyave., 5, Novokuznetsk, Russian Federation, 654005;
2-Institute of Molecular Biology and Biophysics, Timakova str., 2/12, Novosibirsk, 630117, Russian Federation
E-mail: shramko_08@mail.ru

Introduction. Myoma occupies a leading place in the structure of gynecological diseases, reduces the fertility rate and living standardsin females of reproductive age. In 85% cases myoma is combined with adenomyosis, which complicates the treatment and increases a risk for hysterectomy. The aim of the study. Search for markers for choosing an efficient tactics of treatment of patients with various proliferative diseases of the uterus. Materials and methods. The comparative analysis of the expression of genes of estrogen (ER), progesterone (PGR) receptors and tumor suppressor of PTEN was carried out in sample from nodes of myoma, adenomyosis and surrounding myometrium from 54 patients with the use of Real-time RT-PCR. Results. A low level of expression of the PTEN gene in the nodes of leiomyosarcoma (LMS), adenomyosis (A) and associated pathology (M+A) has been established. The level of expression of the PTEN gene was increased in patients with simple myoma (LM) and as high as possible in patients with cell fibroids (CM). In adenomyosis nodes, the level of expression of the ER genes predominated over the expression of the level of the PGR genes, on the contrary, in the myomatous nodes the predominance of PGR gene expression over the expression of the ER genes was established. With the combination of myoma and adenomyosis, the ER and PGR genes were expressed equally and not significantly. Conclusion. The lack of significant expression of steroid receptors in combination with a low level of expression of the PTEN gene in patients with combined pathology does not let us to hope for an efficient therapy with PGR blockers or anti-estrogenic drugs and indicates to a risk of malignant transformation. In the choice of tactics of treatment for such patients, operative treatment is justified. High expression of the ЕRα gene in the surrounding myometrium of patients with cell uterine fibroids has an important pathogenic significance, determining rapid growth of the fibroids and high risk of recurrence. Anti-relapse therapy of patients with cellular myoma should have antiestrogenic direction in the postoperative period
Keywords: 
adenomyosis, uterine fibroids, cell uterine fibroids, leiomyosarcoma, combined pathology, genes of estrogen receptors, genes of progesterone receptors, expression of the genes of steroid receptors, tumor suppressor PTEN