Abstract: Objective To explore the correlation between inflammatory in endometriosis (EMs) tissues collected from patients and ferroptosis as well as its clinical significance. Methods From January 2021 to December 2024, 31 EMs patients who visited the gynecology department of Taizhou Municipal Hospital were selected, and 20 cases of patients with benign gynecological diseases were collected as control group.The lesion endometrium tissues and normal endometrium tissues were sampled. Pain degree of dysmenorrhea, inflammatory injury of endometrium, and ferroptosis-related mRNA/protein in the two groups were observed by HE staining microscopy, real-time PCR or Western blot. The results were statistically analyzed to evaluate the correlation among pain, inflammatory injury of endometrium, and ferroptosis. Results The pain degree of EMs group patients was mainly in the moderate to severe range, while that of the control group patients was mainly in the mild to moderate range. Compared with the control group, the endometrial tissues of the EMs group patients had obvious incomplete tissue structure with a large number of inflammatory cell infiltration. Moreover, the mRNA level of TNF-α, IL-1β, and TGF-β and the protein level of SOD, MDA and GSH in the endometrium of the EMs group patients were significantly increased(P＜0.05); Compared with the control group, the protein expression of GXP4 and CD71 in the endometrium of the EMs group patients were significantly increased (P＜0.001)and the protein expression level of HO-1 was significantly decreased (P＜0.001). Conclusions The pain degree of dysmenorrhea in EMs patients is positively correlated with the inflammatory injury of endometrium and the oxidative stress and ferroptosis in lesion endometrium were found.

Key words: endometriosis, inflammatory injury, ferroptosis, oxidative stress