The relationship between urokinase plasminogen activator/plasminogen activator inhibitor type-1 expression in myoma/myometrium and mechanism of uterine artery occlusion by laparoscopy for uterine myoma treatment.

The objective of the study was to investigate the pattern of expression of plasminogen activator/plasminogen activator inhibitor (PAI) system between myoma and myometrium and its correlation between outcome and laparoscopic uterine artery occlusion prior to myomectomy in the treatment of myoma. mRNA expression of PAI type-1 (PAI-1) and urokinase plasminogen activator (uPA) was detected with real-time PCR in the myoma and myometrium cells primary cultured in vitro, and uPA and PAI-I protein expression was detected with cellular immunity histochemistry. First, the expression of uPA mRNA was 0.123 +/- 0.189 in myoma, which was significantly lower than 0.331 +/- 0.306 in myometrium (P < 0.05); however, the expression of PAI-I mRNA was 0.091 +/- 0.036 in myoma, which was significantly higher than 0.016 +/- 0.020 in myometrium (P < 0.05). Second, the expression of uPA protein was 8.805 +/- 1.645 in myoma cells, which was lower than 22.173 +/- 4.381 in myometrium (P < 0.05); the expression of PAI-I protein was 44.765 +/- 1.090 in myoma cells, which was significantly higher than 35.928 +/- 5.351 in myometrium (P < 0.05). The distinct expression pattern of uPA/PAI in myoma and myometrium might be correlated to the low recurrence rate after uterine artery occlusion prior to myomectomy in the treatment of myoma.