• Ведение пациенток с лейомиомой матки. Консервативные методы лечения (Обзор канадского клинического руководства SOGC)

Ведение пациенток с лейомиомой матки. Консервативные методы лечения (Обзор канадского клинического руководства SOGC)

HEALTH OF WOMAN. 2017.5(121):86–91

Жилка Н. Я.
Национальная медицинская академия последипломного образования имени П.Л. Шупика, г. Киев

Изменения в патогенезе миомы матки, а именно – дополнение существующих теорий уменьшением количества родов у современных женщин и избыточным количеством менструаций, позволяют кроме гормональных методов лечения миомы матки довольно эффективно применять селективные модуляторы рецепторов прогестерона.

Ключевые слова: лейомиома матки, консервативное лечение, селективные модуляторы рецепторов прогестерона.

Литература:

1. Day Baird D, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma m black and white women: ultrasound evidence. Am J Obstet Gynecol 2003;188:100–7. https://doi.org/10.1067/mob.2003.99

2. Munro MG, Cntchley HO, Broder MS, Fraser IS. The FIGO Classi cation System (“PALM­COEIN”) for causes of abnormal uterine bleeding m non­gravid women m the reproductive years, including guidelines for clinical investigation. IntJ Gynaecol Obstet 2011;113:3–13. https://doi.org/10.1016/j.ijgo.2010.11.011; PMid:21345435

3. Bulun SE. Uterine broids. N Engl J Med 2013;369:1344–55. https://doi.org/10.1056/NEJMra1209993; PMid:24088094

4. Flake GP, Andersen J, Dixon D. Etiology and pathophysiology of uterine leiomyomas; a review. Environ Health Perspect 2003;111:1037–54. https://doi.org/10.1289/ehp.5787; PMid:12826476 PMCid:PMC1241553

5. Miura S, Khan KN, Kitajima M, Hiraki K, Monyama S, Masuzaki H, et al. Differential in ltration of macrophages and prostaglandin by different uterine leiomyomas. Hum Reprod 2006;21:2545–54. https://doi.org/10.1093/humrep/del205; PMid:16763009

6. Schwartz LB, Diamond MP, Schwartz PE. Leiomyosarcomas: clinical presentation. Am J Obstet Gynecol 1993;168(1 Pt 1):180–3.

7. Parker WH, Fu YS, Berek JS. Uterine sarcoma m patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol 1994;83:414–8. PMid:8127535

8. Leibsohn S, d’Ablamg G, Mishell DR Jr., Schlaerth JB. Leiomyosarcoma m a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol 1990;162:968­74; discussion 974–6. https://doi.org/10.1016/0002-9378(90)91298-Q

9. Knight J, Falcone T. Tissue extraction by morcellation: a clinical dilemma. J Mm Invas Gynecol 2014;21:319–20. https://doi.org/10.1016/j.jmig.2014.03.005; PMid:24646445

10. Cantuana GH, Anglioli R, Frost L, Duncan R, Penalver MA. Comparison of bimanual examination with ultrasound before hysterectomy for uterine leiomyoma. Obstet Gynecol 1998;92:109–12. https://doi.org/10.1016/S0029-7844(98)00131-8

11. Farquhar C, Ekeroma A, Furness S, Arroll B. A systematic review of transvagmal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding m premenopausal women. Acta Obstet Gynecol Scand 2003;82:493–504. https://doi.org/10.1034/j.1600-0412.2003.00191.x; PMid:12780419

12. Makns N, Kalmantis K, Startados N, Papadimitriou A, Mantzans G, Antsaklis A. Three dimensional hysterosonography versus hysteroscopy for the detection of intracavitary uterine abnormalities. IntJ Gynecol Obstet 2007;95:6–9.

13. Bradley LD, Falcone T, Magen AB. Radiographic imaging techniques for the diagnosis of abnormal uterine bleeding. Obstet Gynecol Clm North Am 2000;27:245–76. https://doi.org/10.1016/S0889-8545(00)80019-4

14. Adusumilli S, Hussain HK, Caoili EM, Weadock WJ, Murray JP, Johnson TD, et al. MRI of sonographically indeterminate adnexal masses. AJR Am J Roentgenol 2006;187:732–40. https://doi.org/10.2214/AJR.05.0905; PMid:16928938

15. Dueholm M, Lundorf E, Hansen ES, Ledertoug S, Olesen F. Accuracy of magnetic resonance imaging and transvagmal ultrasonography m the diagnosis, mapping, and measurement of uterine myomas. Am J Obstet Gynecol 2002;186:409–15. https://doi.org/10.1067/mob.2002.121725; PMid:11904599

16. Omary RA, Vasireddy S, Chnsman HB, Ryu RK, Pereles FS, Carr JC, et al. The effect of pelvic MR imaging on the diagnosis and treatment of women with presumed symptomatic uterine broids. J Vase Interv Radiol 2002;13:1149–53. https://doi.org/10.1016/S1051-0443(07)61957-5

17. Stamatopoulos CP, Mikos T, Grimbizis GF, Dimitnadis AS, Efstratiou I, Stamatopoulos P, et al. Value of magnetic resonance imaging m diagnosis of adenomyosis and myomas of the uterus. J Mm Invas Gynecol 2012:19:620–6. https://doi.org/10.1016/j.jmig.2012.06.003; PMid:22935303

18. Myers ER, Barber MD, Gustilo­Ashby T, Couchman G, Matchar DB, McCrory DC. Management of uterine leiomyomata: what do we really know Obstet Gynecol 2002;100:8–17. https://doi.org/10.1097/00006250-200207000-00003; https://doi.org/10.1016/S0029-7844(02)02019-7

19. Al­Hendy A, Salama S. Gene therapy and uterine leiomyoma: a review. Hum Reprod Update 2006; 12:385–400. https://doi.org/10.1093/humupd/dml015; PMid:16603566

20. Sayed GH, Zakherah MS, El­Nashar SA, Shaaban MM. A randomized clinical trial of a levonorgestrel­releasmg intrauterine system and a low­dose combined oral contraceptive for broid­related menorrhagia. IntJ Gynaecol Obstet 2011;112:126–30. https://doi.org/10.1016/j.ijgo.2010.08.009; PMid:21092958

21. Maruo T, Ohara N, Yoshida S, Nakabayashi K, Sasaki H, Xu Q, et al. Translational research with progesterone receptor modulator motivated by the use of levonorgestrel­releasmg intrauterine system. Contraception 2010;82:435–41. https://doi.org/10.1016/j.contraception.2010.05.006; PMid:20933117

22. Englund K, Blanck A, Gustavsson I, Lundkvist U, Sjoblom P, Norgren A, et al. Sex steroid receptors m human myometrium and broids: changes during the menstrual cycle and gonadotropin­releasing hormone treatment. J Clin Endocrinol Metab 1998 11;83:4092–6. https://doi.org/10.1210/jcem.83.11.5287; https://doi.org/10.1210/jc.83.11.4092

23. Magalhaes J, Aldnghi JM, de Lima GR. Uterine volume and menstrual patterns m users of the levonorgestrel­releasmg intrauterine system with idiopathic menorrhagia or menorrhagia due to leiomyomas. Contraception 2007;75:193–8. https://doi.org/10.1016/j.contraception.2006.11.004; PMid:17303488

24. Verspyck E, Marpeau L, Lucas C. Leuprorelm depot 3.75 mgversus lynestrenol m the preoperative treatment of symptomatic uterine myomas: a multicentre randomised trial. Eur J Obstet Gynecol Reprod Biol 2000;89:7–13. https://doi.org/10.1016/S0301-2115(99)00168-2

25. Sangkomkamhang US, Lumbiganon P, Laopaiboon M, Mol BW. Progestogens or progestogen­releasing intrauterine systems for uterine broids. Cochrane Database Syst Rev 2013; 2:CD008994.

26. Carr BR, Marshburn PB, Weatherall PT, Bradshaw KD, Breslau NA, Byrd W, et al. An evaluation of the effect of gonadotropin­releasing hormone analogs and medroxyprogesterone acetate on uterine leiomyomata volume by magnetic resonance imaging: a prospective, randomized, double blind, placebo­controlled, crossover trial. J Clm Endocrinol Metab 1993;76:1217–23. https://doi.org/10.1210/jc.76.5.1217; https://doi.org/10.1210/jcem.76.5.8496313; PMid:8496313

27. Friedman AJ, Daly M, Juneau­Norcross M, Rem MS, Fine C, Gleason R, et al. A prospective, randomized trial of gonadotropm­releasmg hormone agonist plus estrogen­progestm or progestin “addback” regimens for women with leiomyomata uteri. J Clm Endocrinol Metab 1993;76:1439–45. https://doi.org/10.1210/jc.76.6.1439; https://doi.org/10.1210/jcem.76.6.8501148; PMid:8501148

28. Friedman AJ, Hoffman DI, Comite F, Browneller RW, Miller JD. Treatment of leiomyomata uteri with leuprolide acetate depot: a double­blmd, placebo­controlled, multicenter study. The Leuprolide Study Group. Obstet Gynecol 1991;77:720–5. PMid:1901638

29. Reissmann T, Diednch K, Comaru­Schally AM, Schally AV. Introduction of LHRH­antagonists into the treatment of gynaecological disorders. Human Reprod 1994;9:767–9. https://doi.org/10.1093/oxfordjournals.humrep.a138593

30. Britten JL, Malik M, Levy G, Mendoza M, Cathermo WH. Gonadotropm­releasmg hormone (GnRH) agonist leuprolide acetate and GnRH antagonist cetrorelix acetate directly inhibit leiomyoma extracellular matrix production. Fertil Stenl 2012;98:1299–307. https://doi.org/10.1016/j.fertnstert.2012.07.1123; PMid:22901846

31. Panidis D, Vavilis D, Rousso D, Stergiopoulos K, Kalogeropoulos A. Danazol in uences gonadotropin secretion acting at the hypothalamic level. IntJ Gynaecol Obstet 1994;45:241–6. https://doi.org/10.1016/0020-7292(94)90249-6

32. ACOG Committee on Practice Bulletms­Gynecology. ACOG practice bulletin: surgical alternatives to hysterectomy m the management of leiomyomas. IntJ Gynaecol Obstet 2001;73:285–94. https://doi.org/10.1016/S0020-7292(01)00414-3

33. Ke LQ, Yang K, Li J, Li CM. Danazol for uterine broids. Cochrane Database Syst Rev 2009;3:CD007692.

34. Sumitani H, Shozu M, Segawa T, Murakami K, Yang HJ, Shimada K, et al. In situ estrogen synthesized by aromatase P450 m uterine leiomyoma cells promotes cell growth probably via an autocrme/ mtracrme mechanism. Endocrinology 2000;141:3852–61. https://doi.org/10.1210/endo.141.10.7719; PMid:11014242

35. Song H, Lu D, Navaratnam K, Shi G. Aromatase inhibitors for uterine broids. Cochrane Database Syst Rev 2013;10:CD009505.

36. Wakelmg AE, Dukes M, Bowler J. A potent speci c pure antiestrogen with clinical potential. Cancer Res 1991;51:3867–73.

37. Donnez J, Hervais Vivancos B, Kudela M, Audebert A, Jadoul P. A randomized, placebo­controlled, dose­ranging trial comparing fulvestrant with goserelm m premenopausal patients with uterine ­ broids awaiting hysterectomy. Fertil Stenl 2003;79:1380–9. https://doi.org/10.1016/S0015-0282(03)00261-9

38. Dutertre M, Smith CL. Molecular mechanisms of selective estrogen receptor modulator (SERM) action. J Pharmacol Exp Ther 2000;295:431–7. PMid:11046073

39. Deng L, Wu T, Chen XY, Xie L, YangJ. Selective estrogen receptor modulators (SERMs) for uterine leiomyomas. Cochrane Database Syst Rev 2012;10:CD005287. https://doi.org/10.1002/14651858.CD005287.pub4

40. Chegini N, Ma C, Tang XM, Williams RS. Effects of GnRH analogues, Cadd­back steroid therapy, antiestrogen and antiprogestms on leiomyoma and myometrial smooth muscle cell growth and transforming growth factor­beta expression. Mol Hum Reprod 2002;8:1071–8. https://doi.org/10.1093/molehr/8.12.1071; PMid:12468639

41. Maruo T, Ohara N, WangJ, Matsuo H. Sex steroidal regulation of uterine leiomyoma growth and apoptosis. Hum Reprod Update 2004;10:207–20. https://doi.org/10.1093/humupd/dmh019; PMid:15140868

42. Kawaguschi K, Fujn S, Konishi I, Nanbu Y, Nonogaki H, Mon T. Mitotic activity m uterine leiomyomas during the menstrual cycle. Am J Obstet Gynecol 1989;160:637–41. https://doi.org/10.1016/S0002-9378(89)80046-8

43. Kawaguschi K, Fujn S, Konishi I, Iwai T, Nanbu Y, Nonogaki H, et al. Immunohistochemical analysis of oestrogen receptors, progesterone receptors and Ki­67 m leiomyoma and myometrium during the menstrual cycle and pregnancy. Virchows Arch A Pathol Anat Histopathol 1991;419:309–15. https://doi.org/10.1007/BF01606522

44. Seagaloff A, Weed JC, Sternberg WH, Parson W. The progesterone therapy of human uterine leiomyomas. J Clm Endocrinol Metrab 1949;9:1273–91. https://doi.org/10.1210/jcem-9-12-1273; PMid:15399547

45. Friedman AJ, Daly M, Juneau­Norcross M, Gleason R, Rem MS, LeBoff M. Long­term medical therapy for leiomyomata uteri: a prospective, randomized study of leuprolide acetate depot plus either oestrogen­progestm or progestin c add­back’ for 2 years. Hum Reprod 1994;9:1618–25. https://doi.org/10.1093/oxfordjournals.humrep.a138762; PMid:7836510

46. Chwalisz K, Perez MC, Demanno D, Wmkel C, Schubert G, Eiger W. Selective progesterone receptor modulator development and use m the treatment of leiomyomata and endometriosis. Endocr Rev 2005;26:423–38. https://doi.org/10.1210/er.2005-0001; PMid:15857972

47. Shen Q, Hua Y, Jiang W, Zhang W, Chen M, Zhu X. Effects of mifepristone on uterine leiomyoma m premenopausal women: a meta­analysis. Fertil Steril 2013;100:1722–6. https://doi.org/10.1016/j.fertnstert.2013.08.039; PMid:24094421

48. Chabbert­Buffet N, Pmtiaux­Kairis A, Bouchard P; VA2914 Study Group. Effects of the progesterone receptor modulator VA2914 m a continuous low dose on the hypothalamic­pituitary­ovanan axis and endometrium m normal women: a prospective, randomized, placebo­controlled trial. J Clm Endocrinol Metab 2007;92:3582–9. https://doi.org/10.1210/jc.2006-2816; PMid:17579200

49. Donnez J, Tatarchuk TF, Bouchard P, Puscasiu L, Zakharenko NF, Ivanova T, et al. Ulipnstal acetate versus placebo for broid treatment before surgery. N Engl J Med 2012;366:409–20. https://doi.org/10.1056/NEJMoa1103182; PMid:22296075

50. Donnez J, Tomaszewski J, Vazquez F, Bouchard P, Lemieszczuk B, Baro F, et al. Ulipnstal acetate versus leuprolide acetate for uterine broids. N Engl J Med 2012;366:421–32. https://doi.org/10.1056/NEJMoa1103180; PMid:22296076