Clinical and prognostic significance of immunological biomarkers in abnormal uterine bleeding associated with endometrial dysfunction in women

Abstract

Background. Abnormal uterine bleeding (AUB) is one of the most common gynecological disorders in women of reproductive age, with endometrial dysfunction being a leading cause. Immunological biomarkers, particularly the chemokines CXCL10, CCL2, and CCL5, are considered promising indicators of endometrial inflammation and predictors of bleeding risk. Objective. To assess serum levels of CXCL10, CCL2, and CCL5 in women with AUB associated with endometrial dysfunction and to evaluate their clinical and prognostic significance. Materials and Methods. Between 2022 and 2025, 120 women were examined, including 90 with AUB-E and 30 controls. Serum chemokine concentrations were measured using ELISA on days 5–7 of the menstrual cycle. Statistical analysis was performed with SPSS 26.0. Results. Women with AUB-E demonstrated significantly higher serum levels of CXCL10, CCL2, and CCL5 compared to controls (p<0.001). CXCL10 and CCL2 showed negative correlations with the degree of endometrial dysfunction (r=–0.32; r=–0.27), while CCL5 positively correlated with the duration and frequency of menorrhagia (r=+0.36). The developed logistic regression model (AUC=0.81) proved effective for individualized prediction of bleeding duration. Conclusion. CXCL10, CCL2, and CCL5 are reliable immunological biomarkers in women with AUB-E. Their integration into clinical practice may enhance early risk prediction and support personalized treatment strategies.