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已发表论文
米非司酮相关的子宫内膜变化：综述
Received 21 April 2025
Accepted for publication 7 September 2025
Published 13 September 2025 Volume 2025:18 Pages 5503—5508
DOI https://doi.org/10.2147/IJGM.S535797
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Gauri Agarwal
Qianhui Lin,1 Yun Zhou2
1Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China; 2Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
Correspondence: Yun Zhou, Department of Gynecology, Renmin Hospital of Wuhan University, No. 99 Zhang-Zhidong Road, Wuhan, Hubei Province, 430060, People’s Republic of China, Email yunzhou@whu.edu.cn
Abstract: Mifepristone is a well-established pharmaceutical agent in obstetrics and gynecology, which has expanded its therapeutic applications to Cushing’s syndrome, meningioma, and even mental disease. The incidence of progesterone receptor modulator-associated endometrial changes (PAECs), characterized by cystic glandular dilatation and architectural complexity that mimic endometrial hyperplasia or carcinoma, is increasing. The precise molecular mechanisms remain incompletely understood. Hormonal influences may be central to PAECs pathogenesis. Histological heterogeneity has been observed between ectopic versus eutopic endometrium. The use of mifepristone at low doses (≤ 10 mg/d) in young women during the early follicular phase appears to be safe. Monitoring of estradiol(E2) levels before the management is recommended. Risk assessment and preventive strategies, such as intermittent treatment, transvaginal ultrasound and levonorgestrel intrauterine system (LNG-IUS), should be considered.
Keywords: mifepristone, endometrial changes, progesterone receptor modulator-associated endometrial changes (PAECs), endometrial carcinoma, endometrial hyperplasia
1Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China; 2Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
Correspondence: Yun Zhou, Department of Gynecology, Renmin Hospital of Wuhan University, No. 99 Zhang-Zhidong Road, Wuhan, Hubei Province, 430060, People’s Republic of China, Email yunzhou@whu.edu.cn
Abstract: Mifepristone is a well-established pharmaceutical agent in obstetrics and gynecology, which has expanded its therapeutic applications to Cushing’s syndrome, meningioma, and even mental disease. The incidence of progesterone receptor modulator-associated endometrial changes (PAECs), characterized by cystic glandular dilatation and architectural complexity that mimic endometrial hyperplasia or carcinoma, is increasing. The precise molecular mechanisms remain incompletely understood. Hormonal influences may be central to PAECs pathogenesis. Histological heterogeneity has been observed between ectopic versus eutopic endometrium. The use of mifepristone at low doses (≤ 10 mg/d) in young women during the early follicular phase appears to be safe. Monitoring of estradiol(E2) levels before the management is recommended. Risk assessment and preventive strategies, such as intermittent treatment, transvaginal ultrasound and levonorgestrel intrauterine system (LNG-IUS), should be considered.
Keywords: mifepristone, endometrial changes, progesterone receptor modulator-associated endometrial changes (PAECs), endometrial carcinoma, endometrial hyperplasia