Clinical correlates of leiomyoma estrogen and progesterone receptors among Nigerian women.

OBJECTIVE: To compare the expression of estrogen receptor α (ERα) and progesterone receptor (PR) in myometrium and leiomyomata tissue, and to correlate their expression with symptoms of uterine leiomyomata. METHODS: In a cross-sectional study, intraoperative biopsy samples of leiomyomata and adjacent myometrial specimens were obtained from premenopausal women with uterine leiomyomata treated at a center in Nigeria between September 2013 and August 2014. Immunohistochemistry for ERα and PR expression was performed on the samples. The immunoscores of both receptors were correlated with the size and symptoms of the leiomyomata. RESULTS: Among 60 pairs of samples, leiomyomata had a higher mean expression of ERα (H-score 193.42±64.55 vs 153.29±69.13; P=0.01) and PR (214.86±66.56 vs 171.53±63.53; P<0.001) than did myometrial tissues. The tumor diameter correlated negatively with the immunoscores of both receptors irrespective of age, parity, and body mass index, but this was only significant for PR (ρ=-0.44; P<0.001). Downregulation of PR on leiomyomata was predicted to occur at a diameter of 11cm. Menorrhagia, dysmenorrhea, and infertility occurred independently of steroid-receptor expression. CONCLUSION: Leiomyomata seem to depend on steroid hormones, but only during early tumor development. This could have implications for the selection of patients for medical management, especially with steroid-receptor modulators.

Prevalence and complications of gallstone disease among pregnant women in a Nigerian hospital.

OBJECTIVE: To determine the prevalence of gallstone disease and its complications among pregnant women in a semi-urban Nigerian setting. METHODS: Consecutive consenting pregnant women presenting at the prenatal clinic of a Nigerian tertiary hospital were recruited over an 18-month period. During routine obstetric ultrasound, the presence of gallstones and/or associated sequelae was investigated. Patients' sociodemographic data and hemoglobin genotype were documented. RESULTS: Overall, 1283 pregnant women (14-43 years of age) were included in the study. Thirty-seven (2.9%) had sonographic evidence of gallstones, 26 (2%) had biliary sludge, and 2 (0.2%) had gallbladder polyps. Twenty-one (56.8%) of the 37 women with gallstones were 30 years of age or younger. Only 1 (1.2%) of 85 selected women in the first trimester of pregnancy with no gallstones who were followed throughout pregnancy developed gallstones in the third trimester. Overall, 3 (0.2%) women had clinical and radiologic evidence of acute calculous cholecystitis, 2 of whom underwent laparoscopic cholecystectomy after delivery. CONCLUSION: The present study demonstrated a low prevalence of gallstone disease and its acute complications among pregnant Nigerian women in a semi-urban setting.