Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Is Associated with Cervical Stromal Involvement in Endometrial Cancer Patients - A Cross-Sectional Study in South China

Sep 24, 2026

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Metabolic dysfunction-associated fatty liver disease (MAFLD) represents a major health concern linked to multiple extrahepatic cancers, yet its relationship with endometrial cancer (EC) outcomes is unclear. This cross-sectional study retrospectively analyzed 725 EC patients from January 2012 to December 2020 using logistic regression and Kaplan–Meier survival methods. MAFLD occurred in 27.7% and was associated with cervical stromal involvement (CSI), especially in type I EC; HSI predicted CSI in type I patients without T2DM.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

EC epidemiology and metabolic risk

EC types and prognosis

Cervical stromal involvement and clinical implications

Article Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Is Associated with Cervical Stromal Involvement in Endometrial Cancer Patients: A Cross-Sectional Study in South China Xite Lin 1,2,3,†, Chunxia Chen 4,†, Tingting Jiang 1,2,3, Jincheng Ma 1,2,3, Lixiang Huang 1,2,3, Leyi Huang 1,2,3, Huifang Lei 1, Yao Tong 1, Guanxiang Huang 1,2,3, Xiaodan Mao 1,2,3,* and Pengming Sun 1,2,3, * Citation: Lin, X.; Chen, C.; Jiang, T.; Ma, J.; Huang, L.; Huang, L.; Lei, H.; Tong, Y.; Huang, G.; Mao, X.; et al. Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Is Associated with Cervical Stromal Involvement in Endometrial Cancer Patients: A Cross-Sectional Study in South China. Curr. Oncol. 2023, 30, 3787–3799. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/curroncol30040287](10.3390/curroncol30040287) Received: 1 December 2022 Revised: 26 February 2023 Accepted: 11 March 2023 Published: 29 March 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350001, China 2 Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou 350001, China 3 Fujian Clinical Research Center for Gynecological Oncology, Fujian Maternity and Child Health Hospital, Fuzhou 350001, China 4 Department of Imaging, Fujian Maternity and Child Health Hospital, Afﬁliated Hospital of Fujian Medical University, Fuzhou 350001, China * [Correspondence: maodan1985@fjmu.edu.cn](Correspondence: maodan1985@fjmu.edu.cn) (X.M.); [fmsun1975@fjmu.edu.cn](fmsun1975@fjmu.edu.cn) (P.S.); Tel.: +86-591-8755-8732 (P.S.) † These authors contributed equally to this work. Abstract: Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a signiﬁcant health issue closely associated with multiple extrahepatic cancers. The association between MAFLD and clinical outcomes of endometrial cancer (EC) remains unknown. Methods: We retrospectively included 725 EC patients between January 2012 and December 2020 . The odds ratios (ORs) were calculated using logistic regression analyses. Kaplan–Meier survival curves were used for survival analysis. Results: Among EC patients, the prevalence of MAFLD was 27.7%(201/725, 95% conﬁdence interval (Cl) = 0.245–0.311) . MAFLD was signiﬁcantly associated with cervical stromal involvement (CSI) (OR = 1.974, 95% conﬁdence interval (Cl) = 1.065–3.659, p = 0.031) . There was a signiﬁcant correlation between overall survival (OS) and CSI (HR = 0.31; 95%CI: 0.12–0.83; p = 0.020), while patients with MAFLD had a similar OS to those without MAFLD (p = 0.952) . Moreover, MAFLD was signiﬁcantly associated with CSI in the type I EC subgroup (OR = 2.092, 95% conﬁdence interval (Cl) = 1.060–4.129, p = 0.033), but not in the type II EC subgroup (p = 0.838) . Further logistic regression analysis suggested that the hepatic steatosis index (HSI) was signiﬁcantly associated with CSI among type I EC patients without type 2 diabetes mellitus (T2DM) (OR = 1.079, 95% conﬁdence interval (Cl) = 1.020–1.139, p = 0.012) . Conclusions: About one-quarter of our cohort had MAFLD. MAFLD was associated with the risk of CSI in EC patients, and this association existed in type I EC patients but not in type II EC patients. Furthermore, the HSI can help predict CSI in type I EC patients without T2DM. Keywords: metabolic dysfunction-associated fatty liver disease; endometrial cancer; cervical stromal involvement; hepatic steatosis index 1. Introduct

FAQs

What was the main objective of the study?

To evaluate whether metabolic dysfunction-associated fatty liver disease (MAFLD) is associated with cervical stromal involvement (CSI) and related clinical outcomes in endometrial cancer patients.

How was MAFLD associated with cervical stromal involvement (CSI) in EC patients?

MAFLD prevalence was 27.7%, and MAFLD was significantly associated with CSI in EC patients (OR = 1.974, p = 0.031).

Does the MAFLD-CSI association differ between EC type I and type II?

Yes. The association existed in the type I EC subgroup (OR = 2.092, p = 0.033) but was not significant in the type II subgroup (p = 0.838).

What role did the hepatic steatosis index (HSI) play?

In type I EC patients without T2DM, the hepatic steatosis index (HSI) was significantly associated with CSI (OR = 1.079, p = 0.012).

Sep 24, 2026

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