Ege Hasan Volkan, Temiz Bilal Esat, Usubutun Alp, Ozdemir Deniz Ates, Atakul Muhammed Onur, Cengiz Murat, Akgor Utku, Basaran Derman, Gultekin Murat, Salman Mehmet Coskun, Tuncer Zafer Selcuk, Ozgul Nejat
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye.
Gynecology and Obstetrics Clinic, 29 Mayıs State Hospital, Ankara, Türkiye.
Pathol Oncol Res. 2025 Jun 5;31:1612039. doi: 10.3389/pore.2025.1612039. eCollection 2025.
This study aimed to assess the likelihood of detecting cancer in final pathology and evaluate the accuracy of intraoperative frozen-section assessment in cases of endometrioid intraepithelial neoplasia (EIN).
We included patients diagnosed with EIN at Hacettepe University Hospital who subsequently underwent hysterectomy at the same center between January 2011 and March 2023. EIN diagnoses made at other institutions were re-evaluated and confirmed by co-author gynecopathologists.
A total of 354 patients diagnosed with EIN underwent hysterectomy. The majority of patients (68.5%) had a final diagnosis of EIN. Endometrial cancer (EC) was identified in 11.3% (n = 40) of patients in the final pathology. Advanced age (≥50 years) (OR = 2.52; 95% CI: [1.27-4.96]; p = 0.006) and menopausal status (OR = 2.62; 95% CI: [1.34-5.11]; p = 0.004) were significantly associated with an increased risk of EC. Among 263 patients who underwent intraoperative frozen-section assessment, EC was detected in 12.9% (n = 34). The sensitivity and specificity of frozen-section assessment for EC detection were 41.1% and 100%, respectively. The frozen-section assessment failed to identify only one of the seven patients who required staging surgery.
Our study demonstrates that a preoperative EIN diagnosis carries an 11.3% risk of concurrent EC. Additionally, the likelihood of EC is significantly higher in older and postmenopausal patients. The majority of patients requiring staging surgery were identified by frozen-section assessment. Our findings indicate that frozen-section assessment provides the necessary information for adequate surgical treatment in EIN cases.
本研究旨在评估在最终病理检查中检测到癌症的可能性，并评估子宫内膜样上皮内瘤变（EIN）病例中术中冰冻切片评估的准确性。
我们纳入了在哈杰泰佩大学医院被诊断为EIN且随后于2011年1月至2023年3月在同一中心接受子宫切除术的患者。在其他机构做出的EIN诊断由共同作者妇科病理学家重新评估并确认。
共有354例被诊断为EIN的患者接受了子宫切除术。大多数患者（68.5%）最终诊断为EIN。在最终病理检查中，11.3%（n = 40）的患者被确诊为子宫内膜癌（EC）。高龄（≥50岁）（OR = 2.52；95%置信区间：[1.27 - 4.96]；p = 0.006）和绝经状态（OR = 2.62；95%置信区间：[1.34 - 5.11]；p = 0.004）与EC风险增加显著相关。在263例接受术中冰冻切片评估的患者中，12.9%（n = 34）检测到EC。冰冻切片评估检测EC的敏感性和特异性分别为41.1%和100%。冰冻切片评估仅未能识别出七名需要分期手术的患者中的一名。
我们的研究表明，术前EIN诊断伴有11.3%的并发EC风险。此外，老年和绝经后患者发生EC的可能性显著更高。大多数需要分期手术的患者通过冰冻切片评估得以识别。我们的研究结果表明，冰冻切片评估为EIN病例的充分手术治疗提供了必要信息。
