Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website https://jocmr.elmerjournals.com

Original Article

Volume 17, Number 12, December 2025, pages 726-732

Molecular and Immune Microenvironmental Changes Across Endometrial Lesions: A Comprehensive Immunohistochemical and Clinical Analysis of Progression From Benignity to Carcinoma

Figures

Figure 1.
Figure 1. Distribution of immune microenvironment markers FOXP3, CD68, and CD163.
Figure 2.
Figure 2. Marker expression in cases with and without prior endometrial hyperplasia with atypia.
Figure 3.
Figure 3. (a) Cyclin D1: minimal nuclear expression in eutopic endometrium, moderate in atypical endometriosis, and strong diffuse positivity in carcinoma. (b) P16: weak/focal staining in benign lesions transitions to block-like, diffuse expression in carcinoma, reflecting cell cycle deregulation. (c) FOXP3: nuclear staining of regulatory T cells progressively increases, highlighting the evolving immunosuppressive microenvironment. (d) CD163: cytoplasmic/membranous staining in stromal macrophages intensifies from benign lesions to carcinoma, indicating M2 polarization. (e) Ki67: low nuclear proliferation index in eutopic endometrium and adenomyosis, sharply increasing in atypical endometriosis and carcinoma. All images are at × 400 magnification.

Tables

Table 1. Clinical Characteristics of the Study Population by Group
 
VariableEutopic endometrium (n = 17)Adenomyosis (n = 27)Typical endometriosis (n = 16)Atypical Endometriosis (n = 10)Endometriosis-Associated Carcinoma (n = 24)
Age (mean ± SD), years39.5 ± 5.143.2 ± 6.345.0 ± 5.847.5 ± 6.752.4 ± 7.2
Menstrual status (premenopausal/perimenopausal/postmenopausal)15/2/018/7/210/5/15/3/24/8/12
Hormonal therapy (n, %)2 (11.8%)3 (11.1%)4 (25.0%)5 (50.0%)4 (16.7%)
Major comorbidities (hypertension/diabetes/thyroid disease)2/0/15/2/33/1/22/1/18/3/4

 

Table 2. Marker Expression Across All Histological Groups
 
MarkerEutopic endometriumAdenomyosisTypical endometriosisAtypical endometriosisCarcinoma
Data are expressed as mean ± SD.
Cyclin D12.5 ± 1.513.0 ± 5.021.0 ± 7.036.0 ± 8.041.0 ± 10.0
CDK43.0 ± 1.214.0 ± 5.022.0 ± 6.034.0 ± 7.040.0 ± 9.0
P163.5 ± 2.012.0 ± 4.020.0 ± 6.032.0 ± 7.055.0 ± 8.0
FOXP33.0 ± 1.08.0 ± 3.012.0 ± 5.018.0 ± 6.026.0 ± 7.0
CD684.0 ± 2.012.0 ± 5.022.0 ± 6.030.0 ± 7.038.0 ± 8.0
CD1633.0 ± 1.510.0 ± 4.018.0 ± 5.025.0 ± 6.032.0 ± 7.0