GSDMD/Caspase-1-based evaluation of dydrogesterone in preventing recurrence after hysteroscopic endometrial polypectomy

Objective The research focuses on understanding how GSDMD and Caspase-1, key regulators of pyroptosis, influence postoperative recurrence in Endometrial Polyps (EPs) and examines whether a combined biomarker can effectively predict recurrence likelihood. Methods 264 EP patients (stratified post-surgery into dydrogesterone-treated and control groups) and 132 healthy women were included. Peripheral blood GSDMD-N, Caspase-1, and estrogen concentrations were quantified. Follow-up assessments at one-year post-operation were conducted to examine associations between these pyroptotic markers and clinical outcomes. Results Increases in GSDMD-N and Caspase-1 were observed in EP patients versus healthy subjects ( p < 0.05). A diagnostic AUC of 0.781 was determined for the joint model. Pyroptosis markers correlated positively with FSH//E 2 and negatively with P ( p < 0.05). Recurrent post-surgery cases had higher GSDMD-N/Caspase-1 than non-recurrent ones ( p < 0.05); the predictive AUC of the combined model for recurrence reached 0.727. Conclusion Post-EP recurrence correlates with GSDMD/Caspase-1 levels, and integrating these markers enhances recurrence risk assessment.