{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:42:57Z","timestamp":1790880177798,"version":"4.1.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Early detection and diagnosis are important for improving the therapeutic effect and quality of life in patients with endometrial cancer (EC). This study aimed to analyze the clinical data of different endometrial pathological types in perimenopausal women with abnormal uterine bleeding (AUB) in order to provide evidence for the prevention and early diagnosis of EC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 462 perimenopausal women with AUB were enrolled in this prospective observational study. Endometrial biopsy was performed in patients with suspected endometrial lesions. According to the pathological examination results, the patients were divided into endometrial polyp group (EP) (n = 71), endometrial hyperplasia without atypia group (EH) (n = 59), atypical endometrial hyperplasia (AEH) (n = 36), and EC group (n = 27). The history risk factors and ultrasonic imaging characteristics of endometrium among the four groups were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-seven women were diagnosed with EC (5.84%). The prevalence rate of AEH and EC in the group of 51- to 55-year-old women was significantly higher than that in the groups of 40- to 45-year-old women and of 46- to 50-year-old women (<jats:italic>P &amp;lt;<\/jats:italic> 0.05). The age, body mass index, and history of diabetes gradually increased with the development of endometrial pathological types. In addition, the correlation index of endometrial blood flow increased gradually, and the proportion of uneven endometrial echo, unclear endometrial\u2013myometrial junction (EMJ), and ovarian cyst also increased gradually. However, no statistically significant difference was found when comparing endometrial thickness (ET) and endometrial volume (EV) among endometrial pathological groups (<jats:italic>P &amp;gt;<\/jats:italic> 0.05). The ET, EV, endometrial vascularization index, endometrial flow index, and vascularization flow index in the ovarian cyst group were significantly higher (<jats:italic>P &amp;lt;<\/jats:italic> 0.05), and the proportion of uneven endometrium echo and unclear EMJ were significantly higher compared with that in the non-ovarian cyst group (<jats:italic>P &amp;lt;<\/jats:italic> 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The most common cause of perimenopausal women with AUB was benign endometrial lesions. However, women aged 51\u201355 years old with endometrial high risk factors and ovarian cyst should be alert to AEH and EC. Endometrial biopsy needs to be performed to determine endometrial malignancy in necessity.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1370681","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T05:21:06Z","timestamp":1709184066000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Analysis of clinical data of different endometrial pathological types in perimenopausal women with abnormal uterine bleeding"],"prefix":"10.3389","volume":"14","author":[{"given":"Li","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimin","family":"Quan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1514010","article-title":"Endometrial cancer","volume":"383","author":"Lu","year":"2020","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1056\/NEJMra1514010","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/iji.12463","article-title":"Polymorphisms in IL-1A are associated with endometrial cancer susceptibility among Chinese Han population: a case-control study","volume":"47","author":"Liu","year":"2020","journal-title":"Int J Immunogenet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1093\/annonc\/mdv484","article-title":"ESMO-ESGO-ESTRO Consensus Conference on endometrial cancer: diagnosis, treatment and follow-up","volume":"26","author":"Colombo","year":"2016","journal-title":"Int J Gynecol Cancer"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v90i4.7800","article-title":"Conservative treatment in early stage endometrial cancer: a review","volume":"90","author":"Trojano","year":"2019","journal-title":"Acta BioMed"},{"key":"B6","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1038\/nrendo.2015.82","article-title":"Perimenopause as a neurological transition state","volume":"11","author":"Brinton","year":"2015","journal-title":"Nat Rev Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31961","article-title":"Risk factors for endometrial cancer: an umbrella review of the literature","volume":"145","author":"Raglan","year":"2019","journal-title":"Int J Cancer"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11747","article-title":"Optimizing the ultrasound visualization of the endometrial-myometrial junction (EMJ)","volume":"7","author":"Votino","year":"2015","journal-title":"Facts Views Vis Obgyn"},{"key":"B9","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1186\/s12905-020-00979-7","article-title":"Fecundity disorders in older women: declines in follicular development and endometrial receptivity","volume":"20","author":"Wang","year":"2020","journal-title":"BMC Womens Health"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1287662","article-title":"The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding","volume":"29","author":"Fraser","year":"2011","journal-title":"Semin Reprod Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.06.042","article-title":"Ovarian cysts","volume":"225","author":"Cheng","year":"2021","journal-title":"Am J Obstet Gyneco L"},{"key":"B12","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.bpobgyn.2019.12.005","article-title":"Endometrial cancer prevention in high-risk women","volume":"65","author":"Njoku","year":"2020","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djx214","article-title":"International patterns and trends in endometrial cancer incidence, 1978-2013","volume":"110","author":"Lortet-Tieulent","year":"2018","journal-title":"J Natl Cancer Inst"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000000684","article-title":"The prevalence of endometrial cancer in pre- and postmenopausal Chinese women","volume":"23","author":"Gao","year":"2016","journal-title":"Menopause"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00324-8","article-title":"Endometrial cancer: not your grandmother\u2019s cancer","volume":"122","author":"Mcalpine","year":"2016","journal-title":"Cancer"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-16-0858","article-title":"Global cancer in women: burden and trends","volume":"26","author":"Torre","year":"2017","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21392","article-title":"Cancer screening in the United States, 2017: a review of current American Cancer Society guidelines and current issues in cancer screening","volume":"67","author":"Smith","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"B18","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/jog.14487","article-title":"Guideline for gynecological practice in Japan: Japan Society of Obstetrics and Gynecology and Japan Association of Obstetricians and Gynecologists 2020 edition","volume":"47","author":"Kawaguchi","year":"2021","journal-title":"J Obstet Gynaecol Res"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2017.1358921","article-title":"Abnormal uterine bleeding in perimenopause","volume":"20","author":"Goldstein","year":"2017","journal-title":"Climacteric"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmw042","article-title":"New concepts for an old problem: the diagnosis of endometrial hyperplasia","volume":"23","author":"Sanderson","year":"2017","journal-title":"Hum Reprod Update"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1097\/01.AOG.0000462977.61229.de","article-title":"Practice bulletin no. 149: endometrial cancer","volume":"125","author":"Listed","year":"2015","journal-title":"Obstet Gynecol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.ctim.2019.03.013","article-title":"The effects of physical activity on cancer prevention, treatment and prognosis: a review of the literature","volume":"44","author":"Lugo","year":"2019","journal-title":"Complement Ther Med"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyz174","article-title":"Estrogen\/estrogen receptor promotes the proliferation of endometrial carcinoma cells by enhancing hMOF expression","volume":"50","author":"Qi","year":"2020","journal-title":"Jpn J Clin Oncol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/PGP.0000000000000569","article-title":"Performance characteristics of endometrial sampling in diagnosis of endometrial carcinoma","volume":"39","author":"Taraboanta","year":"2020","journal-title":"Int J Gynecol Pathol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.2298\/vsp110405004p","article-title":"Hysteroscopy and directed biopsy in the diagnosis of endometrial carcinoma","volume":"123","author":"Zhu","year":"2010","journal-title":"Chin Med J (Engl)"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s10397-020-01077-0","article-title":"Hysteroscopic view with targeted biopsy in the assessment of endometrial carcinoma. What is the rate of underestimatated diagnosis? the results of a multicenter Italian trial","volume":"17","author":"Garuti","year":"2020","journal-title":"Gynecological Surg"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14608","article-title":"Fibroid vascularisation assessed with three-dimensional power Doppler ultrasound is a predictor for uterine fibroid growth: a prospective cohort study","volume":"125","author":"Nieuwenhuis","year":"2018","journal-title":"BJOG"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12787","article-title":"Three-dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women","volume":"145","author":"Ni","year":"2019","journal-title":"Int J Gynaecol Obstet"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2007.26.10.1279","article-title":"Clinical usefulness of 3-dimensional sonography and power Doppler angiography for diagnosis of endometrial carcinoma","volume":"26","author":"Merc\u00e9","year":"2007","journal-title":"J Ultrasound Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"78","DOI":"10.5152\/jtgga.2014.07355","article-title":"Value of three dimensional power Doppler ultrasound in prediction of endometrial carcinoma in patients with postmenopausal bleeding","volume":"15","author":"Hanafi","year":"2014","journal-title":"J Turk Ger Gynecol Assoc"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2014\/8649.4542","article-title":"Giant follicular cyst of ovary in an adolescent girl","volume":"8","author":"Rajput","year":"2014","journal-title":"J Clin Diagn Res"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2024.1370681\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T05:21:08Z","timestamp":1709184068000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2024.1370681\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,29]]},"references-count":31,"alternative-id":["10.3389\/fonc.2024.1370681"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2024.1370681","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,29]]},"article-number":"1370681"}}