RESUMO
OBJECTIVE: To investigate the effect of GnRH treatment on estrogen levels and sulfatase activity in leiomyoma and myometrium tissue. DESIGN: Retrospective analyses of tissue obtained in a prospective randomized clinical study. SETTING: Gynecology departments of eight hospitals in the Netherlands. PATIENT(S): Thirty-two patients scheduled for leiomyoma surgery. INTERVENTION(S): Patients were randomized to receive either GnRHa (3.75 mg/4 weeks of triptorelin or 3.6 mg/4 weeks of goserelin) or no GnRHa for 4 months. At subsequent surgery, leiomyoma and myometrium samples were collected. MAIN OUTCOME MEASURE(S): Estrone, estradiol, and sulfatase activity levels in leiomyoma and myometrium. RESULT(S): In myometrium, levels of estrone, estradiol, and sulfatase activity were significantly lower in the treated group (to median values of 46%, 21%, and 61%, respectively). In leiomyomas of treated patients, the reduction in median estrone level (to 65% of untreated value) was comparable to that in myometrium. The reduction in estradiol level in leiomyoma, however, was significantly less than in myometrium (median to 58% vs. 21%), and no significantly lower sulfatase activity was found. CONCLUSION(S): Estradiol and sulfatase results show that the effect of GnRHa treatment on leiomyoma differs from the effect on myometrium, suggesting a continuing estrogenic stimulus in leiomyoma tissue despite treatment.
