子宫内膜癌（EC）和子宫内膜增生的发病机制非常复杂，人们对其知之甚少。自噬已成为这一过程的重要方面。本研究通过研究自噬相关的 4B 半胱氨酸肽酶 (ATG4B) 基因、蛋白和 miR-665-3p 的表达，探讨自噬在 EC 和增生发病机制中的作用患者与对照组相比的水平。这项横断面病例对照研究分析了 90 个子宫内膜组织，包括 30 个肿瘤、30 个正常对照和 30 个增生组织，使用定量逆转录聚合酶链反应和蛋白质印迹来评估 ATG4B 基因和蛋白水平。 EC患者的子宫内膜组织高于增生患者和对照组。此外，EC 和增生患者的 ATG4B 蛋白水平也高于对照组。 EC患者中ATG4B基因表达和蛋白水平呈正相关。然而，在EC患者中，miR-655-3p与ATG4B基因和蛋白水平呈显着负相关。ATG4B基因和蛋白在EC组织中表达升高，提示其作为肿瘤促进剂的作用。评估其水平可以作为监测 EC 进展和预后的标志物。© 2025。亚洲妇科肿瘤学会、韩国妇科肿瘤学会和日本妇科肿瘤学会。

The pathogenesis of endometrial cancer (EC) and hyperplasia is complex and poorly understood. Autophagy has emerged as a crucial aspect of this process.This study examines the role of autophagy in the pathogenesis of EC and hyperplasia by investigating the expression of the autophagy-related 4B cysteine peptidase (ATG4B) gene, protein, and miR-665-3p levels in patients compared to a control group. This cross-sectional case control study analyzed 90 endometrial tissues, including 30 tumors, 30 normal controls, and 30 hyperplasia, using quantitative reverse transcription polymerase chain reaction and Western blot to assess ATG4B gene and protein levels.Higher ATG4B gene expression levels were found in the endometrial tissue of EC patients than in hyperplasia patients and controls. Furthermore, protein levels of ATG4B were also higher in EC and hyperplasia patients than in controls. ATG4B gene expression and protein levels were positively correlated in EC patients. However, in EC patients, miR-655-3p showed a significant negative correlation with the ATG4B gene and protein levels.ATG4B gene and protein expression is elevated in EC tissue, suggesting their role as a tumor promoter. Evaluating their levels could serve as markers for monitoring EC progression and prognosis.© 2025. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.