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Background: Abnormal uterine bleeding associated with ovulatory dysfunction (AUB-O) is a typical gynecological disease that can affect women of various ages. Being able to identify women at risk of AUB-O could allow physicians to take timely action. This study aimed to identify the influencing factors of AUB-O in Chinese women, and then develop and validate a predictive model. Methods: In this multicenter case–control study, 391 women with AUB-O and 838 controls who came from nine hospitals in Zhejiang province were recruited between April 2019 and January 2022. All the participants completed a structured questionnaire including general characteristics, lifestyle and habits, menstrual and reproductive history, and previous diseases. The predictive model was developed on a group of 822 women and validated on a group of 407 women. Logistic regression was adopted to investigate the influencing factors and develop the model, and validation was then performed. Results: The independent predictive factors of AUB-O were age (OR 1.073, 95% CI 1.046—1.102, P < 0.001), body mass index (OR 1.081, 95% CI 1.016—1.151, P = 0.015), systolic blood pressure (OR 1.016, 95% CI 1.002—1.029, P = 0.023), residence (OR 2.451, 95% CI 1.727—3.478, P < 0.001), plant-based diet (OR 2.306, 95% CI 1.415—3.759, P < 0.001), fruits eating (OR 1.887, 95% CI 1.282—2.776, P = 0.001), daily sleep duration (OR 0.819; 95% CI 0.708—0.946, P = 0.007), multiparous (parity = 1, OR 0.424, 95% CI 0.239—0.752, P = 0.003; parity > 1, OR 0.450, 95% CI 0.247—0.822, P = 0.009), and history of ovarian cyst (OR 1.880, 95% CI 1.305—2.710, P < 0.001). The predictive ability (area under the curve) in the development group was 0.77 (95% CI 0.74—0.81), while in the validation group it was 0.73 (95% CI 0.67—0.79). The calibration curve was in high coincidence with the standard curve in the development group, and similar to the validation group. A tool for AUB-O risk calculation was created. Conclusions: Nine influencing factors and a predictive model were proposed in this study, which could identify women who are at high risk of developing AUB-O. This finding highlights the importance of early screening and the lifelong management of ovulatory disorders for women.

Rationale: Inflammatory myofibroblastic tumor (IMT) is a rare soft tissue neoplasm with low malignant potential. These patients present with a certain probability of malignant potential. The management of IMT has not been standardized, especially for the patients with fertility needs. Patient concerns and Diagnoses: Thirteen patients with IMT who attended in the Department of Gynecology, Women’s Hospital, Zhejiang University School of Medicine were enrolled between 2019 and 2023. The data of the clinical and pathological features was analyzed. Interventions and Outcomes: The mean age of the patients was 45.31 ± 12.80 years. Seven of the 13 cases (53.85%) had abnormal uterine bleeding. Five of them (38.46%) had a rapidly growing mass, and 2 of them (15.38%) had no obvious symptoms. With regard to surgical strategies, 7 patients underwent hysterectomy, and 6 patients underwent mass resection only. All the patients were alive with no evidence of disease at an average of 9.58 months of follow-up. One of them gave birth to a full-term male infant at 40 weeks of gestation after hysteroscopic resection, without recurrence. Lessons: Uterine inflammatory myofibroblastic tumor can be diagnosed by the anaplastic lymphoma kinase overexpression. Complete excision under hysteroscopy or laparoscopy seems to be effective and safe. Because there is a certain risk of recurrence and metastasis, conservative surgery should be performed carefully to preserve fertility in patients who can undergo close follow-up.

Background: Preoperative differentiation between uterine mesenchymal tumors and benign uterine fibroids remains challenging in postmenopausal women. This study aimed to develop an exploratory risk-stratification model for uterine mesenchymal tumors and to characterize complementary molecular features of uterine leiomyosarcoma using a public transcriptomic dataset. Methods: A retrospective case–control study was conducted in postmenopausal patients with uterine masses who underwent surgery between 2011 and 2021. A total of 23 uterine mesenchymal tumor cases and 92 frequency-matched fibroid controls were included. Clinical variables were analyzed using univariable and multivariable logistic regression to develop an exploratory risk-stratification model. Model performance was evaluated using ROC analysis, calibration analysis, decision curve analysis, and confusion matrix assessment. Exploratory transcriptomic analysis was performed using the GEO dataset GSE64763 to characterize molecular differences between uterine leiomyosarcoma and fibroid tissues. Results: Pelvic pressure, abnormal uterine bleeding, and tumor diameter were independently associated with uterine mesenchymal tumors. The model achieved an apparent AUC of 0.859 and an optimism-corrected AUC of 0.846 after 1000 bootstrap resamples. Exploratory transcriptomic analysis revealed distinct expression patterns and upregulation of proliferation-associated genes, including CCNB1, BUB1B, PRC1, TOP2A, and FOXM1, with enrichment of cell cycle–related pathways. Conclusions: An exploratory model based on routinely available preoperative variables demonstrated preliminary discriminatory ability within the development cohort. Independent external validation in representative prospective cohorts is required before any assessment of clinical utility.