Epithelial-mesenchymal transition as an important stage in the formation of pathological proliferative diseases of the uterus

E.G. Shvarev, A.R. Zoeva, И. В. Зайцев
In: Russian Bulletin of Obstetrician-Gynecologist · 2025 · vol. 25(4) , pp. 37 · doi:10.17116/rosakush20252504137 · W4413223300
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review discusses epithelial-mesenchymal transition's role in uterine hyperplastic diseases and cancer, proposing menstrual secretions as an alternative diagnostic tool.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

The paper reviews epithelial–mesenchymal transition (EMT) as a key biological stage in the development of pathological proliferative uterine diseases, drawing on evidence from studies of uterine epithelium biology, EMT regulation, and tumor progression mechanisms. It synthesizes findings across topics such as endometrial function and repair, mesenchymal–epithelial plasticity, and EMT involvement in uterine and endometrioid cancer contexts, while discussing molecular pathways and major mechanistic themes. A major limitation is that, as a narrative overview, it does not present new original experiments or a standardized, systematic method to quantify the strength of evidence across included studies. Relevance to endometriosis: the paper cites work connecting EMT/microenvironmental mechanisms to endometriosis, including a question of when EMT occurs in endometriosis, though its main focus is EMT in the formation of pathological proliferative uterine diseases.

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Abstract

The review is devoted to the presentation of modern knowledge about the mechanisms of reversible transformation of epithelial and mesenchymal cells of the endometrium, about the impact of this process on changes in a woman’s reproductive health, including the formation of hyperplastic processes and endometrial cancer. It is known that to study the structural and functional state of the endometrium, a biopsy is usually required, which is currently most often performed by an invasive transcervical method. The presented material suggests consideration of an alternative approach to the diagnosis of these diseases, based on the identification of markers of the epithelial-mesenchymal and mesenchymal-epithelial transition in the menstrual secretions of the examined patients and thereby determining indications for treatment by various methods. The purpose of the review is to provide up—to-date information on the processes of epithelial-mesenchymal and mesenchymal-epithelial transitions, their involvement in the regulation of physiological functions of the uterus, as well as in the pathogenesis of hyperplastic processes in the endometrium and endometrial cancer, and to consider the possibility of forming a new approach to the detection of these diseases. To achieve this goal, a search was conducted for domestic and foreign studies in the Pubmed international citation system published over the past 15 years. Modern data on the main mechanisms of epithelial-mesenchymal and mesenchymal-epithelial transition at the stages of the menstrual cycle in healthy women, as well as during the formation of hyperproliferative endometrial diseases, including the risk of their malignancy, are presented.

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