Background/objectives: Given the risk of a progression, or an undiagnosed endometrial cancer (EC), the treatment of choice is hysterectomy in women with endometrial intraepithelial neoplasia (EIN). The risk of metastatic disease and whether sentinel node (SLN) biopsy should be performed remains unclear. The primary aim of this prospective study was to determine the overall incidence of concurrent EC and the impact of the diagnostic tool used and the type of endometrial lesion. The secondary aim was to investigate the risk of metastatic SLNs. Methods: Between July 2019 and May 2024, 98 consecutive women with EIN deemed suitable for robotic surgery and SLN dissection were included in the study. Ultrastaging and immunohistochemistry were performed on all SLNs. Results: In total, 47% of women with preoperative EIN had EC on final histology; 13% of these had metastatic SLNs and the overall risk of metastases was 6.3%. Women who obtained their diagnosis by an endometrial biopsy had 65% risk of EC. All women with metastatic SLNs had non-polypoid lesions and five out of six obtained their diagnosis through endometrial biopsy. Conclusions: The overall risk of SLN metastases was 6.3%, all in women with a general endometrial thickening and/or a diagnosis of EIN by office endometrial biopsy, suggesting that SLN detection should be offered particularly to women with EIN who fulfill these preoperative criteria.
背景/目的：鉴于子宫内膜上皮内瘤变（EIN）患者存在进展风险或可能患有未确诊的子宫内膜癌（EC），子宫切除术是首选治疗方案。然而，转移性疾病的风险以及是否应进行前哨淋巴结（SLN）活检仍不明确。本研究的主要目的是确定并发EC的总体发生率，并探讨诊断工具类型及子宫内膜病变类型对结果的影响。次要目的是评估SLN转移的风险。方法：2019年7月至2024年5月期间，连续纳入98例适合接受机器人手术及SLN清扫术的EIN患者。对所有SLN进行超分期检测和免疫组化分析。结果：术前诊断为EIN的患者中，最终病理确诊为EC的比例为47%；其中13%存在SLN转移，总体转移风险为6.3%。通过子宫内膜活检确诊的患者中，EC发生风险达65%。所有SLN转移患者均存在非息肉样病变，其中5例（共6例）通过子宫内膜活检确诊。结论：SLN总体转移风险为6.3%，且均发生于存在弥漫性子宫内膜增厚和/或经诊室子宫内膜活检确诊为EIN的患者。这表明，对于符合这些术前标准的EIN患者，应特别建议进行SLN检测。
肿瘤(癌症)患者之家