子宫内膜不典型增生分子标志物的作用机制及研究进展

Research Progress on the Mechanism of Molecular Markers in Endometrial Atypical Hyperplasia

摘要: 子宫内膜不典型增生(endometrial atypical hyperplasia, AH)是女性生殖系统常见的病变之一，其本质是子宫内膜出现病理性改变。近年来随着人口老龄化趋势增加、现代人生活习惯转变等因素影响，其发病率逐年升高，且趋于年轻化。AH患者若不及时进行治疗，发展成子宫内膜癌的风险会显著升高。因此早期精准的筛查及诊治是AH患者改善生存质量，提高生存率的重要环节。目前临床上诊断AH的“金标准”主要依赖于组织病理学检查，但侵入性操作带来的并发症风险与取材局限性，使其难以满足大规模人群筛查需求，因此寻求特异的无创性生物学指标来诊断早期AH尤其重要。目前随着科学进步，分子层面的生物学标志物逐渐浮现，因其可以识别早期、低水平的病理改变，故逐渐成为AH辅助诊断的得力助手。本文梳理近年来AH诊断相关分子标志物的研究进展，并对其发病机制、研究现状、临床应用等方面进行分析，为后续研究提供参考。

Abstract: Endometrial atypical hyperplasia (AH) is one of the common lesions in the female reproductive system, characterized by pathological changes in the endometrium. In recent years, influenced by factors such as population aging and changes in modern lifestyle, the incidence of AH has been increasing year by year and tends to be younger. If left untreated, patients with AH face a significantly elevated risk of developing endometrial cancer. Therefore, early and precise screening and diagnosis are crucial for improving the quality of life and survival rate of AH patients. Currently, the “gold standard” for clinical diagnosis of AH mainly relies on histopathological examination. However, the risk of complications and limitations of sampling associated with invasive procedures make it difficult to meet the needs of large-scale population screening. Thus, it is particularly important to seek specific non-invasive biological indicators for the diagnosis of early AH. With scientific advances, molecular-level biological biomarkers have emerged, as they can more subtly explain the core mechanisms of disease occurrence and development, identify early and low-level pathological changes, and provide new directions for clinical early warning and auxiliary diagnosis, gradually becoming a valuable assistant in the auxiliary diagnosis of AH. This article reviews the recent research progress of AH-related molecular markers and analyzes their pathogenesis, research status, and clinical applications, providing a reference for subsequent studies.