Prediction of proliferative activity of uterine leiomyoma. A model for differential diagnosis of usual-type and cellular leiomyoma

Objective. To study the prognostic significance of clinical, laboratory and ultrasound parameters of usual-type and cellular uterine leiomyoma (UL). Patients and methods. This study is a retro-and prospective multicenter cohort trial. We analyzed clinical, laboratory, ultrasound and immunohistochemical (IHC) data of 100 patients aged 18 to 45 years selected by the random number generation. Patients were divided into two groups based on the results of IHC analysis. Group 1 included 79 patients with usual-type UL, group 2 – 21 patients with proliferative “cellular” UL. Prior to surgery, all patients received a personalized polygonal 3D model of the uterus and uterine fibroids generated using the author’s image processing program with the subsequent possibility of intraoperative navigation. Results. Statistical and mathematical analysis of 458 parameters revealed 20 significant markers for differential diagnosis of usual-type and cellular UL with the determination of the specific frequency of each parameter in scores. The developed scoring system for the prognosis of UL proliferative activity allowed us to predict the morphotype of UL with an accuracy of 83.5% (83% specificity, 89% sensitivity). Conclusion. The differential diagnosis of usual-type and proliferative UL is possible not only retrospectively after analyzing IHC data, but also prospectively. © 2022, Dynasty Publishing House. All rights reserved.