Clinical prognostic value of imaging and immuno-hormonal markers in uterine leiomyoma

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Background: Uterine leiomyoma is a prevalent benign tumor arising from the smooth muscle cells of the uterine wall, profoundly affecting women's reproductive health and overall quality of life. Despite extensive studies on hormonal and molecular genetic mechanisms, its pathogenesis remains incompletely understood. Increasing evidence suggests that cytokines, growth factors, and immune-hormonal interactions may play a key role in tumor progression and recurrence. This study aimed to evaluate the prognostic significance of imaging, immunological, and hormonal markers in the assessment of antitumor immune response and clinical outcomes in women of reproductive age with uterine leiomyoma. Methods: A total of 61 women diagnosed with uterine leiomyoma were examined at the Gynecology Department of Bukhara Outpatient Polyclinic (OPC). Clinical, biochemical, hormonal, and immunological parameters were analyzed using standard laboratory assays and magnetic resonance imaging (MRI). Statistical analysis included comparative, correlational, and regression methods to identify prognostic indicators. Results: Hereditary predisposition, history of medical abortion, and excess body weight were identified as major risk factors. Elevated serum biomarker levels of vascular endothelial growth factor (VEGF) (>95.1 pg/mL), estradiol (>40.5 pg/mL), and fibroblast growth factor-1 (FGF-1) (>81.4 pg/mL) significantly increased the likelihood of leiomyoma development (P<0.05). Enhancing antiproliferative activity of transforming growth factor beta-2 (TGF-β2) and reducing progesterone synthesis reflected impaired growth-factor-mediated regulation and potential neoplastic transformation. Serum levels of cancer antigen 125 (CA-125) and cancer antigen 19-9 (CA-19-9) were significantly elevated in women with uterine leiomyoma compared with controls (P<0.0001). MRI findings demonstrated heterogeneous leiomyoma morphology with variable localization, vascularization, and nodular architecture. Macroscopic examination revealed well-circumscribed firm nodules with a characteristic whorled appearance. Histological analysis confirmed benign smooth muscle proliferation with interlacing fascicles, minimal atypia, connective tissue stroma, and variable fibrotic or vascular changes. Conclusions: Uterine leiomyoma is characterized by elevated tumor markers, hormonal dysregulation, inflammatory and angiogenic activation, and distinct radiological and morphological features. Integrated evaluation of biochemical, imaging, and histopathological parameters may improve diagnostic assessment, characterization of tumor heterogeneity, and individualized management strategies in women with uterine leiomyoma. Integration of imaging findings with immuno-hormonal biomarkers may improve early detection, risk stratification, and individualized management of uterine leiomyoma.

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