AUTHOR=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 

TITLE=Comparison of intraoperative frozen section consultation and hysterectomy characteristics in patients diagnosed with EIN in endometrial biopsies

JOURNAL=Pathology and Oncology Research

VOLUME=Volume 31 - 2025

YEAR=2025

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2025.1612039

DOI=10.3389/pore.2025.1612039

ISSN=1532-2807

ABSTRACT=ObjectiveThis 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).Material and methodsWe 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.ResultsA 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.ConclusionOur 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.