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
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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. Distribution of immune microenvironment markers FOXP3, CD68, and CD163.
Figure 1.
↓  Figure 2. Marker expression in cases with and without prior endometrial hyperplasia with atypia.
Figure 2.
↓  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.
Figure 3.

Tables

↓  Table 1. Clinical Characteristics of the Study Population by Group
 
Variable Eutopic endometrium (n = 17) Adenomyosis (n = 27) Typical endometriosis (n = 16) Atypical Endometriosis (n = 10) Endometriosis-Associated Carcinoma (n = 24)
Age (mean ± SD), years 39.5 ± 5.1 43.2 ± 6.3 45.0 ± 5.8 47.5 ± 6.7 52.4 ± 7.2
Menstrual status (premenopausal/perimenopausal/postmenopausal) 15/2/0 18/7/2 10/5/1 5/3/2 4/8/12
Hormonal therapy (n, %) 2 (11.8%) 3 (11.1%) 4 (25.0%) 5 (50.0%) 4 (16.7%)
Major comorbidities (hypertension/diabetes/thyroid disease) 2/0/1 5/2/3 3/1/2 2/1/1 8/3/4

 

↓  Table 2. Marker Expression Across All Histological Groups
 
Marker Eutopic endometrium Adenomyosis Typical endometriosis Atypical endometriosis Carcinoma
Data are expressed as mean ± SD.
Cyclin D1 2.5 ± 1.5 13.0 ± 5.0 21.0 ± 7.0 36.0 ± 8.0 41.0 ± 10.0
CDK4 3.0 ± 1.2 14.0 ± 5.0 22.0 ± 6.0 34.0 ± 7.0 40.0 ± 9.0
P16 3.5 ± 2.0 12.0 ± 4.0 20.0 ± 6.0 32.0 ± 7.0 55.0 ± 8.0
FOXP3 3.0 ± 1.0 8.0 ± 3.0 12.0 ± 5.0 18.0 ± 6.0 26.0 ± 7.0
CD68 4.0 ± 2.0 12.0 ± 5.0 22.0 ± 6.0 30.0 ± 7.0 38.0 ± 8.0
CD163 3.0 ± 1.5 10.0 ± 4.0 18.0 ± 5.0 25.0 ± 6.0 32.0 ± 7.0