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. 2021 Jun 7;11:11949. doi: 10.1038/s41598-021-90570-3

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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ALDH1 cytoplasmic expression in epithelia is upregulated in patients who ultimately develop endometrial cancer. ALDH1 expression was evaluated in epithelia from patients with (A) histologically normal endometrium, (B) hyperplasia without atypia and (C) atypical hyperplasia, with expression dichotomized into those who developed or did not develop cancer. Epithelial ALDH1 expression predicted increased likelihood of progression to developing cancer in patients with benign endometrium (p = 0.002) and hyperplasia (p = 0.02), but did not reach significance in atypical hyperplasia. (D) Kaplan–Meier plot showing time to progression to cancer for cytoplasmic ALDH1 expression in endometrial hyperplasia with or without atypia: the difference in median time to cancer diagnosis 145 months when ALDH1 negative vs 56 months when ALDH1 was positive, HR = 2.66, p = 7.1e−3.