Work

Development of a clinical diagnostic model for atypical endometrial hyperplasia and endometrial carcinoma in women aged 40–60 years based on refined abnormal uterine bleeding patterns

Year: 2025

Type: article

Abstract: Objective: To develop and validate a diagnostic nomogram model for predicting atypical endometrial hyperplasia (AEH) and endometrial carcinoma (EC) in women aged 40-60 years with abnormal uterine bleeding (AUB), incorporating detailed bleeding patterns and clinical parameters. Methods: This retrospective cohort study included 1,920 patients aged 40-60 years with AUB who underwent hysteroscopic evaluation across four hospital branches from 2021 to 2024. Variables were screened via univariate logistic regression followed by LASSO regression. A multivariate logistic regression model was constructed using seven selected predictors, including age, family history of cancer, endometrial thickness, menstrual blood loss, abnormal menstrual duration, intermenstrual bleeding, and postmenopausal bleeding. Internal validation was performed using bootstrap resampling; external validation was conducted using an independent cohort. Results: The final model demonstrated good discriminatory performance (AUC = 0.814 in the training cohort, 0.762 in external validation). Calibration plots and the Hosmer-Lemeshow test indicated good agreement between predicted and observed probabilities. Decision curve analysis confirmed favorable clinical utility. Patients classified as high-risk (score ≥70.362) had a significantly increased likelihood of AEH/EC (OR = 12.46, 95% CI: 7.56-21.01, P < 0.001). Conclusion: This study presents a validated, user-friendly nomogram integrating refined AUB patterns and clinical variables to support early risk stratification for AEH/EC in women aged 40-60 years. The model demonstrates robust predictive performance and may assist in guiding individualized diagnostic strategies, particularly in resource-limited settings.

Source: Frontiers in Oncology

DOI: 10.3389/fonc.2025.1684604

Authors: Shulin Huang, Xudong Hu, Lingjuan Hu, Tingting Du, Yanchun Zhao, Jing Xiao

Institutions: Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine

Language: English

Topic: Endometrial and Cervical Cancer Treatments

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801