Morphometric and DNA Image Analysis of Endometrial Hyperplasia and Carcinoma. 2017

Sonia L El-Sharkawy, and Naglaa F Abbas, and Ahmed M Y El-Henawy, and Manal A El-Megeed Badawi, and Noha N Yasseen
*Pathology Department, Medical Division, National Research Centre, Giza Governorate †Pathology Department, Faculty of Medicine, Cairo University, Giza, Egypt.

Endometrial hyperplasia is believed to increase the risk of endometrial carcinoma and represents a spectrum of morphologic and biological alterations of endometrial glands and stroma ranging from an exaggerated physiological state to carcinoma in situ. Considering the overlap between the various entities, it is not surprising that the morphologic assessment of endometrial lesions is particularly challenging. This work aimed to evaluate endometrial lesions according to their nuclear and glandular morphometric parameters, their D score, and their DNA ploidy, which help in making an accurate diagnosis. In this study, 50 endometrial biopsy specimens were stained with hematoxylin and eosin for their histopathologic and morphometric study and Feulgen stain for DNA analysis. The cases were classified into 20 cases of simple hyperplasia, 10 cases of atypical hyperplasia, and 20 cases of endometrial carcinoma. Morphometric analysis of nuclear, glandular, and stromal parameters was performed using the Leica Qwin 500 image analysis system. In the studied cases, a significant difference was found in the mean values of the morphometrical parameters of endometrial lesions, including the nuclear area and the nuclear roundness, and all glandular measurements including their complexity, area, volume percentage of stroma, and D score were significantly different. The DNA index and diploid and aneuploid values could differentiate significantly between endometrial lesions. We conclude that nuclear morphometric evaluation of the hyperplastic and carcinomatous endometrium may be used as an ancillary technique in the diagnosis of atypical changes occurring in precancerous endometrial lesions. In addition, DNA and D score assessment may be a reproducible and accurate predictor of the outcome of endometrial hyperplasia and may add some objective criteria for the correct diagnosis of difficult cases.

UI MeSH Term Description Entries
D004273 DNA, Neoplasm DNA present in neoplastic tissue. Neoplasm DNA
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016889 Endometrial Neoplasms Tumors or cancer of ENDOMETRIUM, the mucous lining of the UTERUS. These neoplasms can be benign or malignant. Their classification and grading are based on the various cell types and the percent of undifferentiated cells. Cancer of Endometrium,Endometrial Cancer,Endometrial Carcinoma,Cancer of the Endometrium,Carcinoma of Endometrium,Endometrium Cancer,Neoplasms, Endometrial,Cancer, Endometrial,Cancer, Endometrium,Cancers, Endometrial,Cancers, Endometrium,Carcinoma, Endometrial,Carcinomas, Endometrial,Endometrial Cancers,Endometrial Carcinomas,Endometrial Neoplasm,Endometrium Cancers,Endometrium Carcinoma,Endometrium Carcinomas,Neoplasm, Endometrial

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