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Proliferative, Cell Regulatory and Angiogenic Patterns of Uterine Fibroid in The Oil Rich Region of Nigeria

Beredugo Sylvanus, Oboma, Yibala Ibor, and Tatfeng, Y.M., Corresponding Author

Abstract

Background: Uterine leiomyomas (fibroids) are the most common benign tumours originating from the smooth muscle layer of the uterus. Aim: This study evaluated the expression of CD34, Ki-67, and P16 tumour markers in uterine leiomyoma using immunohistochemistry . Methods: The study was conducted at Niger Delta University Teaching Hospital, Okolobiri, and Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. One hundred formalin-fixed paraffin- embedded uterine leiomyoma tissues from patients who underwent myomectomy between January 2019 and December 2023 were randomly selected for IHC. Data were analysed using IBM SPSS version 25, with statistical significance set at p < 0.05. Results: Uterine fibroids were most common in women aged 30–39 years (33.0%). IHC showed positive expression rates of 100% for CD34, 60% for Ki-67, and 10% for P16. Correlation analysis demonstrated a moderate positive association between Ki-67 and CD34 (p = 0.002), suggesting a link between tumour proliferative activity and vascularity. A weak but significant correlation was also found between Ki-67 and P16 (p = 0.006), while the association between CD34 and P16 was not significant (p = 0.072). Ki-67 expression varied significantly across age groups (p = 0.002), with the highest level in women aged 30–39 years, indicating peak proliferative activity during reproductive age. Women aged 30–39 years had markedly higher odds of Ki-67 positivity (OR = 17.0), whereas those aged 40–49 years and ≥50 years had lower odds (OR = 0.25). CD34 expression odds were lower in women aged 30–39 years (OR = 0.28) and 40–49 years (OR = 0.35) than in those aged 20–29 years. P16 positivity was higher in women aged 30–39 years (OR = 4.67), although its association with age was not significant (p = 0.116). Conclusion: Differential expression of CD34, Ki-67, and P16 reflects variations in tumour proliferation, vascularity, and cell-cycle regulation in uterine leiomyoma. The high incidence among women of reproductive age highlights the public health burden of fibroids and the need for improved screening, early diagnosis, and effective management. Routine tumour marker IJMEPR assessment alongside hormonal evaluation may enhance diagnosis, prognosis, and treatment of uterine leiomyoma. Key words: Uterine leiomyoma, fibroid, IHC, CD34, Ki-67, P16.

Keywords

Uterine leiomyomafibroidIHCCD34Ki-67P16.

References

Kashani, B. N., Centini, G., Morelli, S. S., Weiss, G., & Petraglia, F. (2016). Role of medical management for uterine leiomyomas. Best Practice & Research Clinical Obstetrics & Gynaecology, 34, 85-103. Akinola, L. A., Okohue, J., Ikechebelu, J., Alabi, C. O., & Olumodeji, A. M. (2021). Approach to Management of Submucous Fibroids by Gynaecological Endoscopy Surgeons/Trainees in Nigeria. African Journal of Reproduction and Gynaecological Endoscopy, 6(1), 1-9. Okogbo, F. O., Ezechi, O. C., Loto, O. M., & Ezeobi, P. M. (2011). Uterine Leiomyomata in South Western Nigeria: a clinical study of presentations and management outcome. African Health Sciences, 11(2). Ezeama, C. O., Ikechebelu, J. I., Obiechina, N. J., & Ezeama, N. N. (2012). Clinical Presentation of Uterine Fibroids in Nnewi, Nigeria: A 5. year Review. Annals of medical and health sciences research, 2(2), 114-118. Ekine, A. A., Lawani, L. O., Iyoke, C. A., Jeremiah, I., & Ibrahim, I. A. (2015). Review of the clinical presentation of uterine fibroid and the effect of therapeutic intervention on fertility. Am J Clin Med Res, 3(1), 9-13. Oluwole, A. A., Owie, E., Babah, O. A., Afolabi, B. B., & Oye-Adeniran, B. A. (2015). Epidemiology of Uterine Leiomyomata at the Lagos University Teaching Hospital, Idi- Araba, Lagos. Nigerian Hospital Practice, 15(1-3), 14-20. Senbanjo, O. C., Ottun, T. A., Akinlusi, F. M., Oshodi, Y. A., Rabiu, K. A., & Adewunmi, A. A. (2023). Clinical Presentation of Uterine Leiomyoma and the Outcome of Surgical Management Options in a Nigerian Tertiary Health Facility. Annals of Health Research (The Journal of the Medical and Dental Consultants Association of Nigeria, OOUTH, Sagamu, Nigeria), 9(2), 136-145. Asaolu, O. A., Ejenobo, D. T. E., & Alabi, O. A. (2023). Laparoscopic Myomectomy for Huge Uterine Fibroid in Sub-Saharan Africa: A Case Report. African Journal of Reproduction and Gynaecological Endoscopy, 8(1), 32-36. Stewart, E. A., Cookson, C. L., Gandolfo, R. A., & Schulze-Rath, R. (2022). Epidemiology of uterine fibroids: A systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 129(1).30-39. Styer, A. K., & Rueda, B. R. (2016). The epidemiology and genetics of uterine leiomyoma. Best practice & research Clinical obstetrics & gynaecology, 34, 3-12. Governini, L., Marrocco, C., Semplici, B., Pavone, V., Belmonte, G., Luisi, S., ... & Piomboni, P. (2021). Extracellular matrix remodeling and inflammatory pathway in human endometrium: insights from uterine leiomyomas. Fertility and Sterility, 116(5), 1404- 1414. Shen, Y., Dong, Y. M., Lu, Q., Xu, J., Wu, Y. T., Yun, S. S., & Ren, M. L. (2016). Phenolic environmental estrogens in urine and blood plasma from women with uterine leiomyoma: Epidemiological survey. Journal of Obstetrics and Gynaecology Research, 42(4), 440-445. Alessandrini, L., Astolfi, L., Daloiso, A., Sbaraglia, M., Mondello, T., Zanoletti, E., ... & Marioni, G. (2023). Diagnostic, prognostic, and therapeutic role for angiogenesis markers in head and neck squamous cell carcinoma: a narrative review. International Journal of Molecular Sciences, 24(13), 10733. Bajaj, S., Gopal, N., Clingan, M. J., & Bhatt, S. (2022). A pictorial review of ultrasonography of the FIGO classification for uterine leiomyomas. Abdominal Radiology, 47(1), 341-351. IJMEPR Avwioro, O.G. (2014). Staining In: Histochemistry and tissue pathology principles and techniques, 3rd edition, Claverianum Press Nigeria Limited: 133-168. Zhang, Z., Huang, H., Jiang, K., Liu, W., Xuan, Y., & Lu, W. (2025). Global, regional, and national uterine fibroid burden from 1990 to 2021 and projections to 2050. BMC Women’s Health, 25, 423. Iwuoha, E.C., Uwaegbulam, C.E., Eni, I., & Thomas, J. (2022). Prevalence of Uterine Fibroids Among Women Presenting at Abia State University Teaching Hospital, Abia State: a Five- Year Review. A Medical Journal of Abia State University Medical Students’ Association, 14(1)1-12. Lin, K. Y.-H., Yang, C.-Y., Lam, A., Chang, C. Y.-Y., & Lin, W.-C. (2021). Uterine leiomyoma is associated with the risk of developing endometriosis: A nationwide cohort study involving 156,195 women. PLOS ONE, 16(8), e0256772. Asaturova, A., Zaretsky, A., Rogozhina, A., Tregubova, A., & Badlaeva, A. (2024). Advancements in minimally invasive techniques and biomarkers for the early detection of endometrial cancer: A comprehensive review of novel diagnostic approaches and clinical implications. Journal of Clinical Medicine, 13(24), 7538. Eulálio Filho, W. M. N., Soares, E. A. S., Lima, M. S. O., Brazil, E. D. N., Rodrigues, R. M. M., Zeron, R. M. C., & Costa, P. V. L. (2019). Evaluation of KI-67 expression in uterine leiomyoma and in healthy myometrium: a pilot study. Revista da Associação Médica Brasileira, 65(12), 1459–1463. Raverot, G., Ioachimescu, A., Pivonello, R., Roy, P., Attacks, J., & Corse, C. et al. (2021). Aggressive pituitary tumours and pituitary carcinomas. Nature Reviews Endocrinology, 17(11), 671–684. Kumar, H., Deshwal, A., Datwani, S., & Li, Z. (2025). Decoding high-grade endometrial cancer: A molecular-histologic integration using the cancer genome atlas framework. Journal of Clinical and Translational Pathology, 5(3), 104-113. Eruvwahwe, E. F. E., Alaba, E. U., O. G. E., & Deele, M. B. (2021). Immunohistochemical characterization of genes expressed in leiomyoma using Ki-67 and p53 in patients attending Niger Delta University Teaching Hospital. Journal of Cancer and Tumour International, 11(3), 30–38. Davey, M. G., Hynes, S. O., Kerin, M. J., Miller, N., & Lowery, A. J. (2021). Ki-67 as a prognostic biomarker in invasive breast cancer. Cancers, 13(17), 4455. Yang, Q., Ciebiera, M., Bariani, M. V., Ali, M., Elkafas, H., Boyer, T. G., & Al-Hendy, A. (2022). Comprehensive review of uterine fibroids: developmental origin, pathogenesis, and treatment. Endocrine reviews, 43(4), 678-719. Reuschenbach, M., Vinokurova, S., & von Knebel Doeberitz, M. (2011). HPV-assoziiertes Karzinom des weiblichen Genitaltrakts. Der Pathologe, 32(6), 451-460. Shen, X., Yang, Z., Feng, S., & Li, Y. (2021). Identification of uterine leiomyosarcoma-associated hub genes and immune cell infiltration pattern using weighted co-expression network analysis and CIBERSORT algorithm. World journal of surgical oncology, 19(1), 223. Chen, Y., Xiong, N., Xiao, J., Huang, X., Chen, R., Ye, S., & Tan, X. (2022). Association of uterine fibroids with increased blood pressure: a cross-sectional study and meta- analysis. Hypertension Research, 45(4), 715-721. Thompson, J., Kowalik, A., & Smith, L. (2022). Evaluation of p16 and Ki-67 expression profiles in distinguishing uterine leiomyosarcoma from cellular leiomyoma variants. Journal of Clinical Pathology and Molecular Oncology, 45(2), 112–119. IJMEPR Lee, M., Cheon, K., Chae, B., Hwang, H., Kim, H. K., Chung, Y. J., ... & Kim, M. R. (2018). Analysis of MED12 mutation in multiple uterine leiomyomas in South Korean patients. International journal of medical sciences, 15(2), 124. Radu, P., Zurzu, M., Paic, V., Bratucu, M., Garofil, D., Tigora, A., & Strambu, V. (2023). CD34— Structure, functions and relationship with cancer stem cells. Medicina, 59(5), 938. Kapoor, S., Shenoy, S. P., & Bose, B. (2020). CD34 cells in somatic, regenerative and cancer stem cells: Developmental biology, cell therapy, and omics big data perspective. Journal of cellular biochemistry, 121(5-6), 3058-3069. Stewart, E. A., & Nowak, R. A. (2022). Uterine fibroids: Hiding in plain sight. Physiology, 37, 16– 27. Salas, A., Beltrán-Flores, S., Évora, C., Reyes, R., Montes de Oca, F., Delgado, A., & Almeida, T. A. (2022). Stem Cell Growth and Differentiation in Organ Culture: New Insights for Uterine Fibroid Treatment. Biomedicines, 10(7), 1542. Yin, P., Ono, M., Moravek, M. B., Coon, J. S., Navarro, A., Monsivais, D., & Bulun, S. E. (2015). Human uterine leiomyoma stem/progenitor cells expressing CD34 and CD49b initiate tumours in vivo. The Journal of Clinical Endocrinology & Metabolism, 100(4), E601- E606.