Computerized histomorphometry in the diagnosis of pre-malignant endometrial lesions

Abstract

Accurate diagnosis of precursors to endometrial cancer is a major challenge to pathologists. D-score is well reproducible and predictive of prognosis than the WHO schema, however it is not widely available, this study is an attempt to design a simple workstation for estimation of D-score. Fifteen samples of endometrium with low grade hyperplasia, fifteen proliferative and eight secretory phase endometria were analyzed by light microscopy and stereology. Severeal architectural and karyometric parameters were evaluated and the D-score was calculated. The volume density of stroma (VPS) was significantly higher in proliferative than secretory and hyperplastic endometria. Among the three diagnostic groups, secretory phase endometria have -significantly- the least VPS. The mean values of glandular surface density (outSD) were higher in secretory endometria as compared to proliferative and hyperplastic endometria, however, the differences was statistically insignificant. All of evaluated nuclear parameters are insignificantly differ between hyperplastic and proliferative endometria. The ratio of longest nuclear axis to shortest nuclear axis (D/d) was significantly less in secretory than proliferative and hyperplastic endometriia. Secretory endometria also have significantly lower mean values of shape factor and significantly higher mean values of contour index than proliferative and secretory endometria. 67% of hyperplastic endometria show D-score values < 0. it seems feasible to estimate D-score for suspected EIN lesions using a semi-automated workstation based on the simple stereologic and morphometric principles described in this study, preferably, if fortified by a future comparative study in which a reference method such as the QProdit system is used.