Our study indicated that, compared to the LPD group, HPD group increased autophagosome formation and reduced the number of LDs, up-regulated the mRNA abundances of the beclin1, atg1a, atg1b, atg3, atg101, atg13, atg4b, atg4d, atg5, atg7, atg8a and atg8b, increased the LC3B-II protein expression and the Beclin1 phosphorylation level. Here, ATG4D is linked to disseminated peritoneal leiomyomatosis.