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Fibroid-Associated Heavy Menstrual Bleeding: Correlation Between Clinical Features, Doppler Ultrasound Assessment of Vasculature, and Tissue Gene Expression Profiles

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Abstract

Despite the prevalence of uterine fibroids (Fs), few studies have investigated the links between clinical features and the cellular or molecular mechanisms that drive F growth and development. Such knowledge will ultimately help to differentiate symptomatic from asymptomatic Fs and could result in the development of more effective and individualized treatments. The aim of this study was to investigate the relationship between ultrasound appearance, blood flow, and angiogenic gene expression in F, perifibroid (PM), and distant myometrial (DM) tissues. We hypothesized that angiogenic gene expression would be increased in tissues and participants that showed increased blood flow by Doppler ultrasound. The study was performed using Doppler ultrasound to measure blood flow prior to hysterectomy, with subsequent tissue samples from the F, PM, and DM being investigated for angiogenic gene expression. Overall, PM blood flow (measured as peak systolic velocity [PSV]) was higher than F blood flow, although significant heterogeneity was seen in vascularity and blood flow between different Fs and their surrounding myometrium. We did not find any correlation between PSV and any other clinical or molecular parameter in this study. We identified 19 angiogenesis pathway-related genes with significant differences in expression between F and DM, and 2 genes, matrix metalloproteinase 9 (MMP9) and Neuropilin 2 (NRP2), that were significantly different between F and PM. These results are consistent with subtle differences between PM and DM. Understanding the differences between symptomatic versus asymptomatic Fs may eventually lead to more effective treatments that directly target the source of heavy menstrual bleeding.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Centre for Women’s Health Research, Monash University, Clayton, Victoria, Australia

    Sophia E. Tsiligiannis MBBS, BMedSci & Beverley Vollenhoven MBBS, FRANZCOG, PhD

  2. Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia

    Marina Zaitseva PhD, Martha Hickey MBChB, FRANZCOG, MD & Peter A. W. Rogers PhD

  3. Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia

    Peter R. Coombs DipAppSc BA, MMU & Paul Shekleton MBBS, FRANZCOG

  4. Department of Diagnostic Imaging, Monash Medical Centre, Melbourne, Victoria, Australia

    Peter R. Coombs DipAppSc BA, MMU & Paul Shekleton MBBS, FRANZCOG

  5. Division of Bioinformatics, The Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia

    Moshe Olshansky PhD

  6. Women’s and Children’s Program, Southern Health, Clayton, Victoria, Australia

    Beverley Vollenhoven MBBS, FRANZCOG, PhD

Authors
  1. Sophia E. Tsiligiannis MBBS, BMedSci
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  2. Marina Zaitseva PhD
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  3. Peter R. Coombs DipAppSc BA, MMU
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  6. Martha Hickey MBChB, FRANZCOG, MD
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  8. Peter A. W. Rogers PhD
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Correspondence to Peter A. W. Rogers PhD.

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Tsiligiannis, S.E., Zaitseva, M., Coombs, P.R. et al. Fibroid-Associated Heavy Menstrual Bleeding: Correlation Between Clinical Features, Doppler Ultrasound Assessment of Vasculature, and Tissue Gene Expression Profiles. Reprod. Sci. 20, 361–370 (2013). https://doi.org/10.1177/1933719112459233

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  • DOI: https://doi.org/10.1177/1933719112459233

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