Tropical Journal of Obstetrics and Gynaecology

: 2017  |  Volume : 34  |  Issue : 1  |  Page : 76--77

Biomarkers in uterine leiomyomas and their clinical significance

Seema Dayal 
 Department of Pathology, Rural Institute of Medical Sciences and Research, Saifai Etawah, Uttar Pradesh, India, Nigeria

Correspondence Address:
Seema Dayal
Department of Pathology, Rural Institute of Medical Sciences and Research, Saifai Etawah, Uttar Pradesh, India

How to cite this article:
Dayal S. Biomarkers in uterine leiomyomas and their clinical significance.Trop J Obstet Gynaecol 2017;34:76-77

How to cite this URL:
Dayal S. Biomarkers in uterine leiomyomas and their clinical significance. Trop J Obstet Gynaecol [serial online] 2017 [cited 2022 Jan 25 ];34:76-77
Available from:

Full Text

Leiomyomas are the most common benign smooth muscle uterine neoplasm of the reproductive age group.[1] They are steroid-dependent tumors. Leiomyomas are diagnosed by clinical examination, ultrasonography, and histopathology examination of hysterectomy specimens or excised myomas.[2] Biomarkers are biological compounds that can be obtained from serum or other easily accessible tissues. They are the reflection of physiology or pathology.[3] Biomarkers which are raised in leiomyoma are prolactin, serum total protein, S. HLA-G, VEGF, Ghrelin, lactate dehydrogense A, hypermethylated death-associated protein kinase, CA-125, hematopoietic growth factors, human epididymis protein 4, proteomics, and gonadal hormones.

Prolactin is a protein hormone involved in various mammalian physiologic actions such as lactogenesis. It is also expressed in other tissues including uterine leiomyomas.[4] It is raised in uterine leiomyomas.

Serum protein is lower in patients with leiomyoma probably because these patients are predisposed to abnormal uterine bleed and menorrhagia.[2]

S human leukocyte antigen G (HLA-G) is an antigen of the immune system which is also expressed in uterus. It is elevated in melanoma, ovarian, and breast carcinoma. Basta et al.[5] demonstrated higher levels of HLA-G in patients with leiomyoma.

Vascular endothelial growth factor (VEGF) and hematopoietic growth factor – VEGF is an angiogenic peptide for the growth of tumors. Chen et al.[6] evaluated raised serum VEGF in women with uterine leiomyoma. Similarly, hematopoietic growth factor, such as macrophage colony stimulating factor (M-CSF) and granulocyte colony stimulating (G-CSF), are raised in endometrial carcinomas and leiomyomas.

Ghrelin – It is secreted by the stomach. Markowska [7] found raised levels of ghrelin in women with leiomyoma.

Lactate dehydrogenase A – It is involved in anerobic glycolysis, and its levels are raised in ovarian cancers and leiomyoma.[8]

CA-125 is raised in ovarian carcinoma as well as in patients with endometrial carcinoma and other benign gynecological diseases such as endometriosis, pelvic inflammatory diseases, adenomyosis, and uterine leiomyomas.[9]

Growth hormones – leiomyomas need hormonal milieu for their growth and maintenance as evident by molecular studies that leiomyoma exhibits more estrogen receptors than normal myometrium.[2]


Biomarkers in leiomyoma are useful for diagnosis as well as for prognosis. There are a number of markers that are raised in leiomyoma uteri, however, ideally it should be sensitive, specific, and cost effective.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


1Crum CP. Body of uterus and endometrium. In: Kumar V, Abbas AK, Fauston, editors. Robbins and cotran Pathologic basis of disease. 7th ed. Philadelphia: Saunders; 2004.P1089- 90.
2Dayal S, Kumar A, Verma A. Clinicopathologic correlation of Leiomyoma with clinical findings and secondary changes in a Rural population of North India. Am J Clin Pathol 2014;141:275-9.
3Christenson RH, Duh SH. Methodological and analytic considerations for blood biomarkers. Prog Cardiovasc Dis 2012;55:25-33.
4Myers ER, Barber MD, Gustilo-Ashby T, Couchman G, Mathchar DB, Mc Crory DC. Management of uterine leiomyoma; What do we really know? Obstet Gynecol 2002;100:8-17.
5Basta P, Mach P, Pitynski K, Bednarek W, Klimek M, Zietek J. Differences in blood serum levels of soluble HLA- G concentrations between the menstrual cycle phases and menopause in patients with ovarian endometriosis and uterine leiomyoma. Neuroendocrinol Lett 2009;30:91-8.
6Chen DC, Liu JY, Wu GJ, Ku CH, Su HY, Chen CH. Serum vascular endothelial growth factor 165 levels and uterine fibroid volume. Acta Obstet Gynecol Scand 2005;84:317-21.
7Markowska A, Ziolkowska A, Nowinka K, Malendowicz LK. Elevated blood active ghrelin and normal total ghrelin and obestatin concentrations in uterine leiomyomas. Eur J Gyaecol Oncol 2009;30:281-4.
8Koukourakis MI, Kontomanolis E, Giatromanolaki A, Sivridis E, Liberis V. Serum and tissue LDH levels in patients with breast/gynaecological cancer and benign diseases. Gynecol Obstet Invest 2009;67:162-8.
9Babacan A, Kizilaslan C, Gun I, Muhcu M, Mungen E, Atay V. CA 125 and other tumor markers in uterine leiomyomas and their association with lesion characteristics. Int J Clin Med 2014;7:1078-83.