Predicting concurrent endometrial carcinoma in women with endometrial intraepithelial neoplasia without…

Abstract

Objective

Endometrial intraepithelial neoplasia (EIN) is a premalignant lesion with variable risk of concurrent endometrial carcinoma. Identifying predictors of endometrial carcinoma in women with EIN without pathological suspicion of carcinoma may improve surgical planning.Methods

A retrospective cohort study of patients with EIN who underwent hysterectomy between 2014 and 2024. Preoperative clinical and diagnostic variables were evaluated as predictors of concurrent endometrial carcinoma and incorporated into a multivariable logistic regression model to construct a nomogram. Model discrimination was assessed using the area under the receiver operating characteristic curve. Ridge and Firth penalized regression were performed as sensitivity analyses.Results

The final cohort included 124 women, of whom 18 (14.5%) had concurrent endometrial carcinoma. Type 2 diabetes mellitus was associated with increased odds of concurrent carcinoma (adjusted OR 4.18, 95% CI 1.11-15.69). Hysteroscopy-guided sampling or dilation and curettage was associated with lower odds compared with pipelle biopsy (adjusted OR 0.11, 95% CI 0.02-0.50). A nomogram incorporating age, body mass index, type 2 diabetes mellitus, and diagnostic modality demonstrated an AUC of 0.828 (95% CI 0.725-0.931) and an optimism-corrected AUC of 0.784. Penalized sensitivity analyses yielded consistent findings.Conclusion

A simple preoperative nomogram based on routinely available clinical variables showed promising discrimination for concurrent endometrial carcinoma in women with EIN. Prospective and external validation in independent cohorts is required before clinical implementation.

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BibTeX RIS

BibTeX

@article{zeevi2026predicting,
  title = {{Predicting concurrent endometrial carcinoma in women with endometrial intraepithelial neoplasia without preoperative suspicion of malignancy}},
  author = {Gil Zeevi and Effi Yeoshoua and Chani Dahan and Or Bercovich and Oded Raban and Ariella Jakobson-Setton and Gad Sabah and Ran Matot and Adi Borovich and Ram Eitan},
  journal = {Gynecologic oncology reports},
  year = {2026},
  month = oct,
  doi = {10.1016/j.gore.2026.102236},
  url = {https://europepmc.org/article/PMC/PMC13716957},
  note = {CC BY},
}

RIS

TY  - JOUR
TI  - Predicting concurrent endometrial carcinoma in women with endometrial intraepithelial neoplasia without preoperative suspicion of malignancy
AU  - Gil Zeevi
AU  - Effi Yeoshoua
AU  - Chani Dahan
AU  - Or Bercovich
AU  - Oded Raban
AU  - Ariella Jakobson-Setton
AU  - Gad Sabah
AU  - Ran Matot
AU  - Adi Borovich
AU  - Ram Eitan
PY  - 2026
DA  - 2026/10/01
JO  - Gynecologic oncology reports
DO  - 10.1016/j.gore.2026.102236
UR  - https://europepmc.org/article/PMC/PMC13716957
AB  - Objective  Endometrial intraepithelial neoplasia (EIN) is a premalignant lesion with variable risk of concurrent endometrial carcinoma. Identifying predictors of endometrial carcinoma in women with EIN without pathological suspicion of carcinoma may improve surgical planning.Methods  A retrospective cohort study of patients with EIN who underwent hysterectomy between 2014 and 2024. Preoperative clinical and diagnostic variables were evaluated as predictors of concurrent endometrial carcinoma and incorporated into a multivariable logistic regression model to construct a nomogram. Model discrimination was assessed using the area under the receiver operating characteristic curve. Ridge and Firth penalized regression were performed as sensitivity analyses.Results  The final cohort included 124 women, of whom 18 (14.5%) had concurrent endometrial carcinoma. Type 2 diabetes mellitus was associated with increased odds of concurrent carcinoma (adjusted OR 4.18, 95% CI 1.11-15.69). Hysteroscopy-guided sampling or dilation and curettage was associated with lower odds compared with pipelle biopsy (adjusted OR 0.11, 95% CI 0.02-0.50). A nomogram incorporating age, body mass index, type 2 diabetes mellitus, and diagnostic modality demonstrated an AUC of 0.828 (95% CI 0.725-0.931) and an optimism-corrected AUC of 0.784. Penalized sensitivity analyses yielded consistent findings.Conclusion  A simple preoperative nomogram based on routinely available clinical variables showed promising discrimination for concurrent endometrial carcinoma in women with EIN. Prospective and external validation in independent cohorts is required before clinical implementation.
SN  - 2352-5789
ER  -

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