Endometrial cancer following endometrial intraepithelial neoplasia versus biopsy-diagnosed cancer: clinicopathological and immunohistochemical features.

Authors

Yara Bishara, Avishalom Sharon, Inshirah Sgayer, Raneen Abu Shqara, Lior Lowenstein, Ala Aiob

Published in

European journal of obstetrics, gynecology, and reproductive biology. Volume 326. Pages 115386. Aug 21, 2026. Epub Aug 21, 2026.

Abstract

To compare clinicopathological characteristics and immunohistochemistry-based molecular profiles between endometrial cancers diagnosed after preoperative endometrial interepithelial neoplasia (EIN) and cancers diagnosed preoperatively by biopsy.
This retrospective cohort study included women treated for endometrial cancer at a tertiary referral center from January 2010 through January 2026. The primary comparison included an EIN group, in which carcinoma was diagnosed in the hysterectomy specimen after EIN, and a group with carcinoma confirmed by preoperative biopsy. Clinicopathological data were abstracted from medical records. Molecular assessment used mismatch repair and p53 immunohistochemistry; POLE sequencing was unavailable.
Of 173 patients, 38 comprised the EIN group, 133 had biopsy-diagnosed carcinoma, and two without preoperative biopsy were excluded from the primary comparison. The EIN group had fewer high-grade tumors (4/38 [10.5%] vs 58/133 [43.6%]; p < 0.001), less deep myometrial invasion (13/38 [34.2%] vs 85/132 [64.4%]; p = 0.001), and an earlier stage distribution (p = 0.009). Among patients with complete IHC profiles, NSMP-like, MMR-deficient, and p53-abnormal profiles occurred in 20/33 (60.6%), 7/33 (21.2%), and 6/33 (18.2%) versus 63/133 (47.4%), 28/133 (21.1%), and 42/133 (31.6%), respectively (overall exact p = 0.264).
Endometrial cancers diagnosed after EIN were significantly lower-grade, less invasive, and earlier-stage than biopsy-diagnosed cancers, with no statistically significant difference in the assessed MMR/p53 IHC profiles. These findings support systematic postoperative pathological and molecular risk assessment when carcinoma is identified after EIN.

PMID:
42659888
Bibliographic data and abstract were imported from PubMed on 28 Aug 2026.

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