Upregulation of SOX9 in the eutopic endometrium of adenomyosis and its association with epithelial-mesenchymal transition

This preprint reports a retrospective case-control study assessing whether SOX9 is upregulated in eutopic endometrium of patients with adenomyosis and whether SOX9 expression is associated with epithelial-mesenchymal transition (EMT) marker patterns. Eutopic endometrial tissue was collected from 60 adenomyosis patients and 60 controls undergoing surgery for uterine leiomyomas, and SOX9 plus EMT-related markers (E-cadherin, N-cadherin, Vimentin, Pan-keratin, and Cytokeratin 7) were evaluated by immunohistochemistry and RT-qPCR; multivariate logistic regression tested association with adenomyosis risk. SOX9 protein and mRNA were significantly higher in adenomyosis, and higher SOX9 scores correlated with increased Vimentin and decreased E-cadherin, with SOX9 independently associated with adenomyosis (OR 1.144, P<0.05). A major caveat explicitly noted in the paper context is that it is a preprint and not peer reviewed. This paper is centrally about adenomyosis—specifically SOX9 overexpression in eutopic endometrium and its association with EMT profiles.

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