{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T17:39:55Z","timestamp":1793468395537,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Endometrial intraepithelial neoplasia (EIN)\/atypical endometrial hyperplasia (AEH) carries a substantial risk of concurrent endometrial carcinoma; however, the role of sentinel lymph node (SLN) assessment during hysterectomy remains controversial. We performed an updated systematic review and meta-analysis to quantify concurrent carcinoma and evaluate SLN\/nodal outcomes in women with preoperative EIN\/AEH. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies reporting concurrent carcinoma and\/or SLN\/nodal outcomes in women with preoperative EIN\/AEH undergoing hysterectomy. Proportions were pooled using a random-effects DerSimonian\u2013Laird model with Freeman\u2013Tukey double-arcsine transformation, with subgroup analyses by histological terminology. Risk of bias was assessed using the QUIPS tool. Results: Nineteen studies, including 13,553 women, were included; 14 studies comprising 1174 women contributed to the pooled nodal-positivity estimate. The pooled rate of concurrent carcinoma was 39.6% (95% CI 34.9\u201344.3; I2 = 86%), with rates of 43.8% in AEH\/atypical hyperplasia cohorts and 33.4% in EIN cohorts. Pooled nodal positivity was 3.0% (95% CI 2.1\u20134.0; I2 = 0%) and was predominantly low-volume disease. The pooled bilateral SLN detection rate was 71.6% (95% CI 67.3\u201375.7), and SLN was not associated with excess surgical complications. SLN findings influenced adjuvant treatment decisions in a minority of patients. Conclusion: Concurrent carcinoma occurs in approximately two in five women with preoperative EIN\/AEH, whereas nodal metastasis is uncommon and generally low-volume. SLN mapping appears feasible and may inform adjuvant management in selected patients. However, because this estimate was derived largely from patients already selected for higher-risk features, it does not, by itself, establish that risk-based selection would substantially outperform routine assessment. Taken together with preliminary prospective data, it is more appropriately viewed as hypothesis-generating support for a selective, risk-stratified approach, pending larger prospective validation.<\/jats:p>","DOI":"10.3390\/diagnostics16193114","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T08:09:02Z","timestamp":1790323742000},"page":"3114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sentinel Lymph Node Assessment in Endometrial Intraepithelial Neoplasia\/Atypical Endometrial Hyperplasia: An Updated Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8845-2471","authenticated-orcid":false,"given":"Pei-Chen","family":"Li","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"},{"name":"Department of Obstetrics and Gynecology, Tainan Sin-Lau Hospital, Tainan 701, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5105-068X","authenticated-orcid":false,"given":"Dah-Ching","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"},{"name":"Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Chou, A.-J., Bing, R.-S., and Ding, D.-C. 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