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- 2018
Vitamin D receptor and cyclooxygenase-2 expression in uterine leiomyoma tissues and their correlationDOI: 10.21037/18678 Abstract: Uterine leiomyomas are the most common gynecological benign tumors in females, clinically affecting more than 25% of reproductive age females and causing significant morbidity (1,2). Although some leiomyomas don’t cause any symptoms, symptomatic leiomyomas are usually associated with specific symptoms such as anemia, abnormal uterine bleeding, abdominal distention, pelvic pain and frequent micturition. Uterine leiomyomas are the most common diseases for hysterectomy in the United States and they cost at least 6 billion dollars annually (3). Despite the fact that uterine leiomyomas are very common and cause significant medical and economic burdens, the etiology is still partially understood. The occurrence and development of uterine fibroids may be relevant to certain risk factors such as estrogen, progestogen, growth factors and ethnicity, but the exact causes are not yet well known (4,5). Recently, some studies indicated that lower serum vitamin D levels are inversely relevant to leiomyoma burden in different ethnic groups and vitamin D inadequacy may be associated with the occurrence of uterine leiomyomas (6,7). Inflammation can be considered as the 7th hallmark of cancer (8). The causality between the inflammation and tumor proliferation may be explained that the injury caused by the infection causes cellular proliferation and the extracellular matrix growth due to pro-inflammatory and growth factors. Furthermore, it decreases cellular apoptosis and abnormal tissue repair. And chronic inflammation may be a risk for the development of uterine leiomyomas (9). Cyclooxygenase-2 (COX-2) plays a key role in inflammatory processes and in control of cell growth, and it has also been associated with tumorigenesis. Vitamin D can inhibit the inflammatory process by vitamin D receptor (VDR). So far, there are few studies about VDR and COX-2 concomitant expression in uterine leiomyomas. In this study, we found that VDR expression decreased and COX-2 expression increased in uterine leiomyomas, and there was a certain correlation between VDR and COX-2, which may play a role in the etiopathogenesis of uterine leiomyomas
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