title: Endometrial intraepithelial neoplasia: clinical correlates and outcomes.
abstract: OBJECTIVE
  To estimate cancer outcome and outcome predictors of women with endometrial intraepithelial neoplasia (EIN).
  
  
  METHODS
  Outcomes of women with first diagnosis of EIN ("index biopsy") were determined by follow-up pathology. Patient characteristics were correlated with EIN regression, EIN persistence, and progression to cancer.
  
  
  RESULTS
  Fifteen percent (95% confidence interval [CI] 9.8-20.8%, 26 of 177) of index EIN biopsy samples had concurrent cancer. Of the women with cancer-free index EIN biopsy samples and follow-up by hysterectomy or more than 18 months of surveillance, 25% (95% CI 18.4-33.3%, 36 of 142) showed regression, 35% (95% CI 27.4-43.7%, 50 of 142) showed persistence, and 39% (95% CI 31.3-48.0%, 56 of 142) showed progression. Nonwhite ethnicity and progestin treatment reduced cancer outcomes (odds ratio [OR] 0.16, 95% CI 0.03-0.84 and OR 0.24, 95% CI 0.08-0.70, respectively), whereas body mass index greater than 25 increased malignant outcomes (body mass index 25 or higher, OR 3.05, 95% CI 1.10-8.45).
  
  
  CONCLUSIONS
  Endometrial intraepithelial neoplasia confers a high risk of cancer, but individual patient outcomes cannot be predicted. Management should include exclusion of concurrent carcinoma and consideration of hysterectomy.
authors.affiliation: From the Departments of Obstetrics and Gynecology and Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Luwam G
authors.initials: LG
authors.lastname: Semere
authors.forename: Emily
authors.initials: E
authors.lastname: Ko
authors.forename: Natasha R
authors.initials: NR
authors.lastname: Johnson
authors.forename: Allison F
authors.initials: AF
authors.lastname: Vitonis
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Phang
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Cramer
authors.forename: George L
authors.initials: GL
authors.lastname: Mutter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000601:surgery*; D016022:Case-Control Studies; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome