Ultra-structure changes and survivin expression in uterine fibroids after radiofrequency ablation

Abstract

Purpose: To explore the reliability and validity of radiofrequency (RF) ablation in treating uterine fibroids. Materials and methods: We evaluated 63 patients who underwent hysterectomy to treat multiple fibroids. Thirty patients immediately underwent abdominal hysterectomy after the fibroids were ablated under direct vision. Thirty-three patients first experienced trans-vaginal ablation with the guidance of a baseline ultrasound. We performed abdominal or trans-vaginal hysterectomy 72 h later. The tissues in the centre of the ablated lesion (group A), at the edge of the ablated lesion (group B), 1 cm away from the ablated edge (group C) and the control group were sampled. We observed ultra-structure changes by transmission electron microscopy and detected survivin expression with Western blot analysis. Results: According to transmission electron microscopy, the ultra-structure of fibroid cells in groups A and B was damaged. However, in group C, the ultra-structure was normal. Compared with the control group, survivin expression was significantly decreased. Meanwhile survivin expression was significantly increased with the distance to the ablated centre (p < 0.05). Conclusions: Radiofrequency ablation caused permanent and irreversible damage to fibroid cells and decreased survivin expression, which provided reliable clinical evidence for the success of radiofrequency ablation treating uterine fibroids.