{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T11:34:09Z","timestamp":1767008049490,"version":"3.46.0"},"reference-count":58,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU H2020-RISE project TRENDO","award":["101008193"],"award-info":[{"award-number":["101008193"]}]},{"name":"German Academic Exchange Service (DAAD) German Egyptian Research Long-Term Scholarship program","award":["91664677"],"award-info":[{"award-number":["91664677"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Adenomyosis, a prevalent gynecologic condition involving invasion of endometrial tissue into the myometrium, remains poorly understood in terms of its molecular pathogenesis. Numb, an important regulator of cellular destiny and stem cell maintenance, has been implicated in numerous proliferative diseases; however, the role for Numb in adenomyosis has not yet been investigated. This research examines the degree to which Numb protein may play a role in the pathogenesis of adenomyosis and additional invasive endometrial diseases. This study analyzed Numb protein expression in tissues from 21 adenomyosis patients and 14 controls using immunohistochemistry. Numb levels were evaluated in eutopic endometrium, ectopic lesions, and myometrium. Additionally, comprehensive bioinformatics analyses were performed including TCGA expression analysis, STRING protein\u2013protein interaction network analysis, and Kaplan\u2013Meier survival analysis to elucidate the clinical significance and mechanistic role of NUMB in endometrial pathology linked to invasive growth. Compared to controls (p &lt; 0.001), adenomyosis patients\u2019 eutopic endometrium and myometrium showed considerably higher levels of numb expression. It was predominantly observed in single cells rather than clusters. No significant variation was noted across menstrual cycle phases. Elevated Numb levels in the myometrium suggest a potential role in tissue invasion. TCGA analysis revealed significant associations between NUMB alterations and expression patterns in endometrial carcinoma, with copy number alterations showing a dose-dependent relationship with the expression levels. STRING network analysis identified NUMB as a central hub protein with 20 high-confidence interactions, particularly enriched in Notch signaling pathway components (FDR = 1.0 \u00d7 10\u221215). Kaplan\u2013Meier survival analysis demonstrated that endometrial carcinoma patients with NUMB alterations had significantly better overall survival compared to unaltered cases (p = 9.119 \u00d7 10\u22123), with 92% vs. 73% survival at 100 months. This study presents new evidence of elevated Numb expression in adenomyosis, suggesting that it may play a part in the pathophysiology of the disease and that it is a useful marker for dysregulation of endometrial stem cells. The comprehensive bioinformatics analyses establish NUMB as a central regulator of endometrial homeostasis with significant prognostic value in endometrial malignancies, providing mechanistic insights into the pathogenesis of invasive endometrial diseases and identifying potential therapeutic targets.<\/jats:p>","DOI":"10.3390\/cimb47121027","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:20:57Z","timestamp":1765369257000},"page":"1027","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["NUMB in Endometrial Pathology: From Adenomyosis Expression Patterns to Endometrial Cancer Survival Implications"],"prefix":"10.3390","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2576-2269","authenticated-orcid":false,"given":"Walid","family":"Shaalan","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, 48149 M\u00fcnster, Germany"},{"name":"Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3189-8063","authenticated-orcid":false,"given":"Nourhan","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, 48149 M\u00fcnster, Germany"},{"name":"Biotechnology Department, Faculty of Science, Cairo University, Giza 12613, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Gamal","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, 48149 M\u00fcnster, Germany"},{"name":"Team Kinderwunsch Oldenburg GbR MVZ, 26121 Oldenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9725-1716","authenticated-orcid":false,"given":"Benedikt","family":"Sch\u00e4fgen","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, 48149 M\u00fcnster, Germany"},{"name":"Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrin","family":"Ha\u00dfdenteufel","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9640-1973","authenticated-orcid":false,"given":"Julia","family":"Gallwas","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, G\u00f6ttingen University Hospital, Robert-Koch-Street 40, 37075 G\u00f6ttingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7247-9247","authenticated-orcid":false,"given":"Ludwig","family":"Kiesel","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas N.","family":"Sch\u00fcring","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2360-2496","authenticated-orcid":false,"given":"Martin","family":"G\u00f6tte","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, 48149 M\u00fcnster, Germany"},{"name":"Cells in Motion Interfaculty Centre, University of M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jmig.2015.09.018","article-title":"Adenomyosis: A Clinical Review of a Challenging Gynecologic Condition","volume":"23","author":"Struble","year":"2016","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"283","DOI":"10.12688\/f1000research.17242.1","article-title":"Recent Advances in Understanding and Managing Adenomyosis","volume":"8","author":"Vannuccini","year":"2019","journal-title":"F1000Research"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1055\/s-0040-1718920","article-title":"Epidemiology of Adenomyosis","volume":"38","author":"Upson","year":"2020","journal-title":"Semin. Reprod. Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Vannuccini, S., Meleca, C., Toscano, F., Mertino, P., Pampaloni, F., Fambrini, M., Bruni, V., and Petraglia, F. (2024). Adenomyosis Diagnosis among Adolescents and Young Women with Dysmenorrhoea and Heavy Menstrual Bleeding. Reprod. Biomed. Online, 48.","DOI":"10.1016\/j.rbmo.2023.103768"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1055\/s-0033-1350840","article-title":"Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy","volume":"73","author":"Taran","year":"2013","journal-title":"Geburtshilfe Frauenheilkd."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s13669-022-00326-7","article-title":"Mechanisms and Pathogenesis of Adenomyosis","volume":"11","author":"Rossi","year":"2022","journal-title":"Curr. Obstet. Gynecol. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.rbmo.2017.06.016","article-title":"Pathogenesis of Adenomyosis: An Update on Molecular Mechanisms","volume":"35","author":"Vannuccini","year":"2017","journal-title":"Reprod. Biomed. Online"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Khan, K.N., Fujishita, A., and Mori, T. (2022). Pathogenesis of Human Adenomyosis: Current Understanding and Its Association with Infertility. J. Clin. Med., 11.","DOI":"10.3390\/jcm11144057"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/cyto.990020104","article-title":"Flow Cytometric Analysis of the Uptake of Hoechst 33342 Dye by Human Lymphocytes","volume":"2","author":"Kiss","year":"1981","journal-title":"Cytometry"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Masuda, H., Maruyama, T., Gargett, C.E., Miyazaki, K., Matsuzaki, Y., Okano, H., and Tanaka, M. (2015). Endometrial Side Population Cells: Potential Adult Stem\/Progenitor Cells in Endometrium1. Biol. Reprod., 93.","DOI":"10.1095\/biolreprod.115.131490"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Masuda, H., Matsuzaki, Y., Hiratsu, E., Ono, M., Nagashima, T., Kajitani, T., Arase, T., Oda, H., Uchida, H., and Asada, H. (2010). Stem Cell-Like Properties of the Endometrial Side Population: Implication in Endometrial Regeneration. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0010387"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102432","DOI":"10.1016\/j.bpobgyn.2023.102432","article-title":"Endometriosis and Adenomyosis: Similarities and Differences","volume":"92","author":"Donnez","year":"2024","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s12015-020-10075-w","article-title":"Uterine Stem Cells and Benign Gynecological Disorders: Role in Pathobiology and Therapeutic Implications","volume":"17","author":"Afrin","year":"2021","journal-title":"Stem Cell Rev. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/j.gendis.2022.08.009","article-title":"Endometrial Stem\/Progenitor Cells: Properties, Origins, and Functions","volume":"10","author":"Hong","year":"2023","journal-title":"Genes Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1007\/s10815-007-9149-2","article-title":"The Role of Chorionic Gonadotropin and Notch1 in Implantation","volume":"24","author":"Afshar","year":"2007","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2884","DOI":"10.1210\/en.2011-2122","article-title":"Notch1 Is Regulated by Chorionic Gonadotropin and Progesterone in Endometrial Stromal Cells and Modulates Decidualization in Primates","volume":"153","author":"Afshar","year":"2012","journal-title":"Endocrinology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1038\/s41392-022-00934-y","article-title":"Notch Signaling Pathway: Architecture, Disease, and Therapeutics","volume":"7","author":"Zhou","year":"2022","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.bbamcr.2011.09.014","article-title":"Notch Signaling Proteins HES-1 and Hey-1 Bind to Insulin Degrading Enzyme (IDE) Proximal Promoter and Repress Its Transcription and Activity: Implications for Cellular A\u03b2 Metabolism","volume":"1823","author":"Leal","year":"2012","journal-title":"Biochim. Biophys. Acta (BBA)\u2014Mol. Cell Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2754","DOI":"10.1002\/art.23730","article-title":"Repression of Chondrogenesis through Binding of Notch Signaling Proteins HES-1 and HEY-1 to N-box Domains in the COL2A1 Enhancer Site","volume":"58","author":"Grogan","year":"2008","journal-title":"Arthritis Rheum."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"20628","DOI":"10.1074\/jbc.M117.800946","article-title":"Mammalian Numb Protein Antagonizes Notch by Controlling Postendocytic Trafficking of the Notch Ligand Delta-like 4","volume":"292","author":"Shao","year":"2017","journal-title":"J. Biol. Chem."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1177\/0284185115626478","article-title":"MR Appearance of Normal Uterine Endometrium Considering Menstrual Cycle: Differentiation with Benign and Malignant Endometrial Lesions","volume":"57","author":"Shitano","year":"2016","journal-title":"Acta Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/rmb2.12221","article-title":"Cancer Driver Mutations in Endometriosis: Variations on the Major Theme of Fibrogenesis","volume":"17","author":"Guo","year":"2018","journal-title":"Reprod. Med. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1177\/1947601911410224","article-title":"P53, Stem Cells, and Reprogramming: Tumor Suppression beyond Guarding the Genome","volume":"2","author":"Spike","year":"2011","journal-title":"Genes. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1002\/hep.27987","article-title":"NUMB Phosphorylation Destabilizes P53 and Promotes Self-renewal of Tumor-initiating Cells by a NANOG-dependent Mechanism in Liver Cancer","volume":"62","author":"Siddique","year":"2015","journal-title":"Hepatology"},{"key":"ref_25","first-page":"796052","article-title":"Syndecan-1 in Cancer: Implications for Cell Signaling, Differentiation, and Prognostication","volume":"2015","author":"Hjerpe","year":"2015","journal-title":"Dis. Markers"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Szatm\u00e1ri, T., and Dobra, K. (2013). The Role of Syndecan-1 in Cellular Signaling and Its Effects on Heparan Sulfate Biosynthesis in Mesenchymal Tumors. Front. Oncol., 3.","DOI":"10.3389\/fonc.2013.00310"},{"key":"ref_27","first-page":"8379256","article-title":"Syndecan-1 Acts as an Important Regulator of CXCL1 Expression and Cellular Interaction of Human Endometrial Stromal and Trophoblast Cells","volume":"2017","author":"Pour","year":"2017","journal-title":"Mediat. Inflamm."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"R1092","DOI":"10.1016\/j.cub.2015.09.049","article-title":"Endocytic Trafficking of Integrins in Cell Migration","volume":"25","author":"Paul","year":"2015","journal-title":"Curr. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"26427","DOI":"10.1074\/jbc.M109.014845","article-title":"Numb Regulates Post-Endocytic Trafficking and Degradation of Notch1","volume":"284","author":"McGill","year":"2009","journal-title":"J. Biol. Chem."},{"key":"ref_30","first-page":"137","article-title":"Endometrial Stem\/Progenitor Cells: The First 10 Years","volume":"22","author":"Gargett","year":"2016","journal-title":"Hum. Reprod. Update"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1210\/er.2018-00242","article-title":"Endometriosis","volume":"40","author":"Bulun","year":"2019","journal-title":"Endocr. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.fertnstert.2023.03.006","article-title":"Endometriosis and Adenomyosis: Shared Pathophysiology","volume":"119","author":"Bulun","year":"2023","journal-title":"Fertil. Steril."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1177\/1933719117691141","article-title":"Molecular Characteristics of the Endometrium in Uterine Adenomyosis and Its Biochemical Microenvironment","volume":"24","author":"Yen","year":"2017","journal-title":"Reprod. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/j.1469-7580.2008.00963.x","article-title":"The Pattern of Expression of Notch Protein Members in Normal and Pathological Endometrium","volume":"213","author":"Cobellis","year":"2008","journal-title":"J. Anat."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1007\/s12032-012-0438-y","article-title":"Down-Regulated Expression of Notch Signaling Molecules in Human Endometrial Cancer","volume":"30","author":"Jonusiene","year":"2013","journal-title":"Med. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5492","DOI":"10.18632\/oncotarget.23695","article-title":"Exon 3 Mutations of CTNNB1 Drive Tumorigenesis: A Review","volume":"9","author":"Gao","year":"2018","journal-title":"Oncotarget"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.rbmo.2017.11.010","article-title":"The Endometrial Stem Cell Markers Notch-1 and Numb Are Associated with Endometriosis","volume":"36","author":"Dahlhues","year":"2018","journal-title":"Reprod. Biomed. Online"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Ortega-Campos, S.M., and Garc\u00eda-Heredia, J.M. (2023). The Multitasker Protein: A Look at the Multiple Capabilities of NUMB. Cells, 12.","DOI":"10.3390\/cells12020333"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"10472","DOI":"10.1073\/pnas.96.18.10472","article-title":"Distinct Human NUMB Isoforms Regulate Differentiation vs. Proliferation in the Neuronal Lineage","volume":"96","author":"Verdi","year":"1999","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/(SICI)1521-1878(199802)20:2<103::AID-BIES1>3.0.CO;2-U","article-title":"A Growing Family of Notch Ligands","volume":"20","author":"Lendahl","year":"1998","journal-title":"BioEssays"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1083\/jcb.201712007","article-title":"Rewired Notch\/P53 by Numb\u2019ing Mdm2","volume":"217","author":"Kim","year":"2018","journal-title":"J. Cell Biol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"33097","DOI":"10.1074\/jbc.274.46.33097","article-title":"Characterization of Four Mammalian Numb Protein Isoforms","volume":"274","author":"Dho","year":"1999","journal-title":"J. Biol. Chem."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/S0006-291X(03)00282-1","article-title":"Mammalian Numb Is a Target Protein of Mdm2, Ubiquitin Ligase","volume":"302","author":"Yogosawa","year":"2003","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.devcel.2007.05.003","article-title":"Numb Controls Integrin Endocytosis for Directional Cell Migration with APKC and PAR-3","volume":"13","author":"Nishimura","year":"2007","journal-title":"Dev. Cell"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/cr.2016.34","article-title":"Numb Regulates Vesicular Docking for Homotypic Fusion of Early Endosomes via Membrane Recruitment of Mon1b","volume":"26","author":"Shao","year":"2016","journal-title":"Cell Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1016\/j.cell.2006.10.041","article-title":"Postnatal Deletion of Numb\/Numblike Reveals Repair and Remodeling Capacity in the Subventricular Neurogenic Niche","volume":"127","author":"Kuo","year":"2006","journal-title":"Cell"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1091\/mbc.e04-10-0867","article-title":"Rab11 in Recycling Endosomes Regulates the Sorting and Basolateral Transport of E-Cadherin","volume":"16","author":"Lock","year":"2005","journal-title":"Mol. Biol. Cell"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"109822","DOI":"10.1016\/j.cellsig.2020.109822","article-title":"Cell-Surface Heparan Sulfate Proteoglycans as Multifunctional Integrators of Signaling in Cancer","volume":"77","author":"Hassan","year":"2021","journal-title":"Cell. Signal."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S0945-053X(98)90095-6","article-title":"Syndecan Proteoglycans and Cell Adhesion","volume":"17","author":"Woods","year":"1998","journal-title":"Matrix Biol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/aogs.15012","article-title":"Decreased Expression of Syndecan-1 (CD138) in the Endometrium of Adenomyosis Patients Suggests a Potential Pathogenetic Role","volume":"104","author":"Shaalan","year":"2025","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/0002-9378(72)90781-8","article-title":"The Elusive Adenomyosis of the Uterus\u2014Revisited","volume":"112","author":"Bird","year":"1972","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/S0002-9378(16)33500-1","article-title":"Dating the Endometrial Biopsy","volume":"122","author":"Noyes","year":"1975","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_53","first-page":"1286","article-title":"Batch Immunostaining for Large-Scale Protein Detection in the Whole Monkey Brain","volume":"29","author":"Zangenehpour","year":"2009","journal-title":"J. Vis. Exp."},{"key":"ref_54","first-page":"CD012658","article-title":"Levonorgestrel-Releasing Intrauterine System for Endometrial Hyperplasia","volume":"9","author":"Mittermeier","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.anndiagpath.2006.08.011","article-title":"Adenomyosis Involved by Endometrial Adenocarcinoma Is a Significant Risk Factor for Deep Myometrial Invasion","volume":"11","author":"Ismiil","year":"2007","journal-title":"Ann. Diagn. Pathol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Qi, S., Zhao, X., Li, M., Zhang, X., Lu, Z., Yang, C., Zhang, C., Zhang, H., and Zhang, N. (2015). Aberrant Expression of Notch1\/Numb\/Snail Signaling, an Epithelial Mesenchymal Transition Related Pathway, in Adenomyosis. Reprod. Biol. Endocrinol., 13.","DOI":"10.1186\/s12958-015-0084-2"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"864","DOI":"10.7150\/ijbs.89795","article-title":"Endometrial Stem Cells: Orchestrating Dynamic Regeneration of Endometrium and Their Implications in Diverse Endometrial Disorders","volume":"20","author":"Hong","year":"2024","journal-title":"Int. J. Biol. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.jmig.2011.04.004","article-title":"Adenomyosis: Review of the Literature","volume":"18","author":"Garcia","year":"2011","journal-title":"J. Minim. Invasive Gynecol."}],"container-title":["Current Issues in Molecular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1467-3045\/47\/12\/1027\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:02:09Z","timestamp":1765371729000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1467-3045\/47\/12\/1027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,10]]},"references-count":58,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["cimb47121027"],"URL":"https:\/\/doi.org\/10.3390\/cimb47121027","relation":{},"ISSN":["1467-3045"],"issn-type":[{"value":"1467-3045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,10]]}}}