{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T22:08:46Z","timestamp":1772489326793,"version":"3.50.1"},"reference-count":66,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,7,25]],"date-time":"2021-07-25T00:00:00Z","timestamp":1627171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Uterine fibroids are the most common mesenchymal uterine neoplasms; their prevalence is estimated in 40%\u201360% of women under 35 and in 70%\u201380% of women over 50 years of age. The current research aims to focus on the etiopathogenesis of uterine fibroids, the factors that affect their growth, and markers with diagnostic and prognostic properties. The MCM (minichromosome maintenance) protein family consists of peptides whose primary function is participation in the molecular mechanism of creating replication forks while regulating DNA synthesis. The aim of this work was to determine the proliferative potential of uterine fibroid cells based on the expression of the Ki-67 antigen and the MCMs\u2014i.e., MCM-3, MCM-5, and MCM-7. In addition, the expression of estrogen (ER) and progesterone (PgR) receptors was evaluated and correlated with the expression of the abovementioned observations. Ultimately, received results were analyzed in terms of clinical and pathological data. Materials and methods: In forty-four cases of uterine fibroids, immunohistochemical reactions were performed. A tissue microarray (TMA) technique was utilized and analyzed cases were assessed in triplicate. Immunohistochemistry was performed using antibodies against Ki-67 antigen, ER, PgR, MCM-3, MCM-5, and MCM-8 on an automated staining platform. Reactions were digitalized by a histologic scanner and quantified utilizing dedicated software for nuclear analysis. Assessment was based on quantification expression of the three histiospots, each representing one case in TMA. Results: In the study group (uterine fibroids), statistically significant stronger expression of all the investigated MCMs was observed, as compared to the control group. In addition, moderate and strong positive correlations were found between all tested proliferative markers. The expression of the MCM-7 protein also correlated positively with ER and PgR. With regard to clinical and pathological data, there was a negative correlation between the expression of MCMs and the number of both pregnancies and births. Significant reductions in MCM-5 and MCM-7 expression were observed in the group of women receiving oral hormonal contraceptives, while smoking women showed an increase in MCM-7, ER, and PgR. Conclusions: Uterine fibroid cells have greater proliferative potential, as evaluated by expression of the Ki-67 antigen and MCMs, than unaltered myometrial cells of the uterine corpus. The expression of MCM-7 was found to have strong or moderate correlations in all assessed relations. In the context of the clinical data, as well evident proliferative potential of MCMs, further studies are strongly recommended.<\/jats:p>","DOI":"10.3390\/cimb43020058","type":"journal-article","created":{"date-parts":[[2021,7,25]],"date-time":"2021-07-25T22:07:00Z","timestamp":1627250820000},"page":"802-817","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Immunohistochemical Expression of MCM-3, -5, and -7 Proteins in the Uterine Fibroids"],"prefix":"10.3390","volume":"43","author":[{"given":"Piotr","family":"Rubisz","sequence":"first","affiliation":[{"name":"Gynecological Surgery, Endometriosis Treatment Center, Medicus Hospital, 50-224 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Hirnle","sequence":"additional","affiliation":[{"name":"First Department of Gynecology and Obstetrics, Wroclaw Medical University, 50-368 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8023-8585","authenticated-orcid":false,"given":"Christopher","family":"Kobierzycki","sequence":"additional","affiliation":[{"name":"Division of Histology and Embryology, Department of Histology and Human Morphology, Wroclaw Medical University, 50-368 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ejogrb.2010.05.012","article-title":"The burden of uterine fibroids in five European countries","volume":"152","author":"Downes","year":"2010","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_2","first-page":"100","article-title":"Uterine fibroid tumors: Diagnosis and treatment","volume":"95","author":"Buchanan","year":"2017","journal-title":"Am. Fam. Physician"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1067\/mob.2003.99","article-title":"High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence","volume":"188","author":"Baird","year":"2003","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1111\/j.0001-6349.2004.00502.x","article-title":"Ki-67 expression in patients with uterine leiomyomas, uterine smooth muscle tumors of uncertain malignant potential (STUMP) and uterine leiomyosarcomas (LMS)","volume":"83","author":"Mayerhofer","year":"2004","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/S0029-7844(97)00534-6","article-title":"Variation in the Incidence of Uterine Leiomyoma Among Premenopausal Women by Age and Race","volume":"90","author":"Marshall","year":"1997","journal-title":"Obstet. Gynecol."},{"key":"ref_6","unstructured":"Kurman, R.J. (2002). Mesenchymal Tumors of the Uterus. Blaustein\u2019s Pathology of the Female Genital Tract, Springer. [5th ed.]."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"16043","DOI":"10.1038\/nrdp.2016.43","article-title":"Uterine fibroids","volume":"2","author":"Stewart","year":"2016","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"168.e1","DOI":"10.1016\/j.ajog.2007.05.038","article-title":"The impact of race as a risk factor for symptom severity and age at diagnosis of uterine leiomyomata among affected sisters","volume":"198","author":"Huyck","year":"2008","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1289\/ehp.0901423","article-title":"Association of Intrauterine and Early-Life Exposures with Diagnosis of Uterine Leiomyomata by 35 Years of Age in the Sister Study","volume":"118","author":"Baird","year":"2010","journal-title":"Environ. Heal. Perspect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1111\/j.1471-0528.1996.tb09911.x","article-title":"Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: A multicentre case-control study","volume":"103","author":"Lumbiganon","year":"1996","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/S0015-0282(98)00208-8","article-title":"A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata","volume":"70","author":"Marshall","year":"1998","journal-title":"Fertil. Steril."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1016\/j.fertnstert.2010.04.065","article-title":"Reproductive characteristics and risk of uterine leiomyomata","volume":"94","author":"Terry","year":"2010","journal-title":"Fertil. Steril."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1093\/aje\/153.1.20","article-title":"Risk Factors for Uterine Fibroids among Women Undergoing Tubal Sterilization","volume":"153","author":"Chen","year":"2001","journal-title":"Am. J. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/j.fertnstert.2007.11.015","article-title":"Combined differential gene expression profile and pathway enrichment analyses to elucidate the molecular mechanisms of uterine leiomyoma after gonadotropin-releasing hormone treatment","volume":"90","author":"Chen","year":"2008","journal-title":"Fertil. Steril."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/00001648-199607000-00018","article-title":"Reproductive Factors and Risk of Uterine Fibroids","volume":"7","author":"Parazzini","year":"1996","journal-title":"Epidemiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1136\/bmj.293.6543.359","article-title":"Risk factors for uterine fibroids: Reduced risk associated with oral contraceptives","volume":"293","author":"Ross","year":"1986","journal-title":"BMJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/aje\/kwh016","article-title":"Reproductive Factors, Hormonal Contraception, and Risk of Uterine Leiomyomata in African-American Women: A Prospective Study","volume":"159","author":"Wise","year":"2004","journal-title":"Am. J. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"858","DOI":"10.2105\/AJPH.86.6.858","article-title":"Risk factors for self-reported uterine fibroids: A case-control study","volume":"86","author":"Samadi","year":"1996","journal-title":"Am. J. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/00001648-199809000-00007","article-title":"Risk of Uterine Leiomyomata among Premenopausal Women in Relation to Body Size and Cigarette Smoking","volume":"9","author":"Marshall","year":"1998","journal-title":"Epidemiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1093\/humrep\/deh309","article-title":"Risk of uterine leiomyomata in relation to tobacco, alcohol and caffeine consumption in the Black Women\u2019s Health Study","volume":"19","author":"Wise","year":"2004","journal-title":"Hum. Reprod."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1017\/S0007114508083566","article-title":"Association of intakes of fat, dietary fibre, soya isoflavones and alcohol with uter-ine fibroids in Japanese women","volume":"101","author":"Nagata","year":"2009","journal-title":"Br. J. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1093\/jnci\/85.9.722","article-title":"Effects of Alcohol Consumption on Plasma and Urinary Hormone Concentrations in Premenopausal Women","volume":"85","author":"Reichman","year":"1993","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1056\/NEJMcp1411029","article-title":"Clinical practice. Uterine Fibroids","volume":"372","author":"Stewart","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_24","first-page":"316","article-title":"Uterine myomas and smoking. Results from an Italian study","volume":"41","author":"Parazzini","year":"1996","journal-title":"J. Reprod. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S0015-0282(16)49517-8","article-title":"Constituents of cigarette smoke inhibit human granulosa cell aromatase","volume":"46","author":"Barbieri","year":"1986","journal-title":"Fertil. Steril."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJM198611203152101","article-title":"Increased 2-Hydroxylation of Estradiol as a Possible Mechanism for the Anti-Estrogenic Effect of Cigarette Smoking","volume":"315","author":"Michnovicz","year":"1986","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1042\/BST0360114","article-title":"The MCM helicase: Linking checkpoints to the replication fork","volume":"36","author":"Forsburg","year":"2008","journal-title":"Biochem. Soc. Trans."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1098\/rstb.2005.1656","article-title":"The Croonian Lecture 2001 Hunting the antisocial cancer cell: MCM proteins and their exploitation","volume":"360","author":"Laskey","year":"2005","journal-title":"Philos. Trans. R. Soc. Lond B Biol. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.yexmp.2009.09.015","article-title":"Minichromosome maintenance protein 3 is a candidate proliferation marker in papillary thyroid carcinoma","volume":"88","author":"Lee","year":"2010","journal-title":"Exp. Mol. Pathol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Hua, C., Zhao, G., Li, Y., and Bie, L. (2014). Minichromosome Maintenance (MCM) Family as potential diagnostic and prognostic tumor markers for human gliomas. BMC Cancer, 14.","DOI":"10.1186\/1471-2407-14-526"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3479","DOI":"10.7314\/APJCP.2013.14.6.3479","article-title":"MCM3 as a Novel Diagnostic Marker in Benign and Malignant Salivary Gland Tumors","volume":"14","author":"Ashkavandi","year":"2013","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/1746-1596-7-82","article-title":"High MCM3 expression is an independent biomarker of poor prognosis and correlates with reduced RBM3 expression in a prospective cohort of malignant melanoma","volume":"7","author":"Nodin","year":"2012","journal-title":"Diagn. Pathol."},{"key":"ref_33","first-page":"5375","article-title":"Comparison of minichromosome maintenance proteins (MCM-3, MCM-7) and metallothioneins (MT-I\/II, MT-III) expression in relation to clinicopathological data in ovarian cancer","volume":"33","author":"Kobierzycki","year":"2013","journal-title":"Anticancer Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/nmeth.3252","article-title":"Orchestrating high-throughput genomic analysis with Bioconductor","volume":"12","author":"Huber","year":"2015","journal-title":"Nat. Methods"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s00268-005-0308-2","article-title":"Diagnostic and Prognostic Value of Cell-cycle Regulatory Genes in Malignant Thyroid Neoplasms","volume":"30","author":"Kebebew","year":"2006","journal-title":"World J. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1136\/jcp.2004.018895","article-title":"p16INK4A, CDC6, and MCM5: Predictive biomarkers in cervical preinvasive neoplasia and cervical cancer","volume":"58","author":"Murphy","year":"2005","journal-title":"J. Clin. Pathol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1111\/jop.12134","article-title":"Increased expression of MCM5 is significantly associated with aggressive progression and poor prognosis of oral squamous cell carcinoma","volume":"43","author":"Yu","year":"2014","journal-title":"J. Oral Pathol. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2748","DOI":"10.1128\/MCB.18.5.2748","article-title":"Negative Regulation of DNA Replication by the Retinoblastoma Protein Is Mediated by Its Association with MCM7","volume":"18","author":"Sterner","year":"1998","journal-title":"Mol. Cell. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0014-5793(00)02117-7","article-title":"The MAT1 cyclin-dependent kinase-activating kinase (CAK) assembly\/targeting factor interacts physically with the MCM7 DNA licensing factor","volume":"484","author":"Wang","year":"2000","journal-title":"FEBS Lett."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1002\/(SICI)1097-4644(20000301)76:3<499::AID-JCB16>3.0.CO;2-4","article-title":"Protein-protein interaction of FHL2, a LIM domain protein preferentially ex-pressed in human heart, with hCDC47","volume":"76","author":"Chan","year":"2000","journal-title":"J. Cell Biochem."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"14152","DOI":"10.1073\/pnas.0606698103","article-title":"Identification of biomarkers that distinguish human papillomavirus (HPV)-positive versus HPV-negative head and neck cancers in a mouse model","volume":"103","author":"Strati","year":"2006","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1136\/jcp.2004.016436","article-title":"DNA replication regulation protein Mcm7 as a marker of proliferation in prostate cancer","volume":"57","author":"Padmanabhan","year":"2004","journal-title":"J. Clin. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2484","DOI":"10.1038\/sj.onc.1207345","article-title":"Identification of genes associated with tumorigenesis and metastatic potential of hypopharyngeal cancer by microarray analysis","volume":"23","author":"Cromer","year":"2004","journal-title":"Oncogene"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Rubisz, P., Ciebiera, M., Hirnle, L., Zgliczy\u0144ska, M., \u0141ozi\u0144ski, T., Dzi\u0119giel, P., and Kobierzycki, C. (2019). The Usefulness of Immunohistochemistry in the Differential Diagnosis of Lesions Originating from the Myometrium. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20051136"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1593\/neo.04295","article-title":"Gene Expression Profiling of Microdissected Pancreatic Ductal Carcinomas Using High-Density DNA Microarrays","volume":"6","author":"Pilarsky","year":"2004","journal-title":"Neoplasia"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1210\/me.2012-1075","article-title":"miR-93\/106b and Their Host Gene, MCM7, Are Differentially Expressed in Leiomyomas and Functionally Target F3 and IL-8","volume":"26","author":"Chuang","year":"2012","journal-title":"Mol. Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1097\/PGP.0000000000000616","article-title":"Combination of MCM2 With Ki67 and p16 Immunohistochemistry Can Distinguish Uterine Leiomyosarcomas","volume":"39","author":"Keyhanian","year":"2020","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/00004347-199504000-00007","article-title":"Leiomyosarcoma versus bizarre and cellular leiomyomas of the uterus: A comparative study based on the MIB-1 and proliferating cell nuclear antigen indices, p53 expression, DNA flow cytometry, and muscle specific actins","volume":"14","author":"Amada","year":"1995","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/00004347-199901000-00004","article-title":"Expression of Steroid Receptors, Ki-67, and p53 in Uterine Leiomyosarcomas","volume":"18","author":"Zhai","year":"1999","journal-title":"Int. J. Gynecol. Pathol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.ygyno.2005.05.019","article-title":"The expression of Ki-67, p53, estrogen and progesterone receptors affecting survival in uterine leiomyosarcomas. A clinicopathologic study","volume":"99","author":"Akhan","year":"2005","journal-title":"Gynecol. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1053\/hupa.2001.27113","article-title":"MIB-1 (Ki-67), p53, estrogen receptor, and progesterone receptor expression in uterine smooth muscle tumors","volume":"32","author":"Mittal","year":"2001","journal-title":"Hum. Pathol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1746-1596-7-1","article-title":"Diagnostic value of progesterone receptor and p53 expression in uterine smooth muscle tumors","volume":"7","author":"Hewedi","year":"2012","journal-title":"Diagn. Pathol."},{"key":"ref_53","first-page":"99","article-title":"Molecular markers of carcinogenesis in the diagnostics of cervical cancer","volume":"63","author":"Bedkowska","year":"2009","journal-title":"Post\u0119py Higieny i Medycyny Do\u015bwiadczalnej"},{"key":"ref_54","first-page":"627","article-title":"[The role of MCM proteins in cell proliferation and tumorigenesis]","volume":"64","year":"2010","journal-title":"Post\u0119py Higieny i Medycyny Do\u015bwiadczalnej"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1111\/j.1365-4632.2007.03335.x","article-title":"Expression of minichromosome maintenance 5 protein in proliferative and malignant skin diseases","volume":"46","author":"Liu","year":"2007","journal-title":"Int. J. Dermatol."},{"key":"ref_56","first-page":"2121","article-title":"Minichromosome Maintenance Proteins as Biological Markers of Dysplasia and Malignancy","volume":"5","author":"Freeman","year":"1999","journal-title":"Clin. Cancer Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1038\/sj.bjc.6603679","article-title":"MCM immunocytochemistry as a first line cervical screening test in developing countries: A prospective cohort study in a regional cancer centre in India","volume":"96","author":"Mukherjee","year":"2007","journal-title":"Br. J. Cancer"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"635","DOI":"10.3892\/ijo.2015.3273","article-title":"Correlation between levels of expression of minichromosome maintenance proteins, Ki-67 proliferation antigen and metallothionein I\/II in laryngeal squamous cell cancer","volume":"48","author":"Nowinska","year":"2016","journal-title":"Int. J. Oncol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1093\/jnci\/94.14.1071","article-title":"Diagnosis of Genito-Urinary Tract Cancer by Detection of Minichromosome Maintenance 5 Protein in Urine Sediments","volume":"94","author":"Stoeber","year":"2002","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/path.1711620403","article-title":"Proliferating cell nuclear antigen (PCNA) immunolocalization in paraffin sections: An index of cell proliferation with evidence of deregulated expression in some, neoplasms","volume":"162","author":"Hall","year":"1990","journal-title":"J. Pathol."},{"key":"ref_61","first-page":"671","article-title":"Pregnancy-related changes in the size of uterine leiomyomas","volume":"51","author":"Neiger","year":"2006","journal-title":"J. Reprod. Med"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"14021","DOI":"10.1073\/pnas.0601271103","article-title":"Progesterone blocks estrogen-induced DNA synthesis through the inhibition of replication licensing","volume":"103","author":"Pan","year":"2006","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1016\/j.fertnstert.2008.08.074","article-title":"Risk factors for surgically removed fibroids in a large cohort of teachers","volume":"92","author":"Templeman","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2188\/jea.12.249","article-title":"Familial Aggregation of Uterine Myomas in Japanese Women","volume":"12","author":"Sato","year":"2002","journal-title":"J. Epidemiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0378-5122(00)00160-2","article-title":"Heritability and risk factors of uterine fibroids\u2014The Finnish Twin Cohort Study","volume":"37","author":"Luoto","year":"2000","journal-title":"Maturitas"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1002\/cncr.10382","article-title":"Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma","volume":"94","author":"Kawamura","year":"2002","journal-title":"Cancer"}],"container-title":["Current Issues in Molecular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1467-3045\/43\/2\/58\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:34:43Z","timestamp":1760164483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1467-3045\/43\/2\/58"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,25]]},"references-count":66,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["cimb43020058"],"URL":"https:\/\/doi.org\/10.3390\/cimb43020058","relation":{},"ISSN":["1467-3045"],"issn-type":[{"value":"1467-3045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,25]]}}}