Prospective Multicenter Evaluation of the Morphometric D-Score for Prediction of the Outcome of Endometrial Hyperplasias
- 1 July 2001
- journal article
- research article
- Published by Wolters Kluwer Health in The American Journal of Surgical Pathology
- Vol. 25 (7), 930-935
- https://doi.org/10.1097/00000478-200107000-00012
Abstract
Prospective multicenter evaluation of the WHO classification and the morphometric D-score to predict endometrial hyperplasia cancer progression. In 132 endometrial hyperplasias WHO classification was performed by two experienced gynecologic pathologists. The D-score was assessed blindly by technicians in a routine diagnostic setting. Development of endometrial carcinoma during a 1–10-year follow-up was used as the end point. Eleven of 132 patients (8%), 10 of 61 (16%) atypical hyperplasias, and 1 of 71 (1%) nonatypical hyperplasias developed cancer. Twenty-six curettings had a D-score ≤0 (“unfavorable” or endometrial intraepithelial neoplasia) of which 10 (38%) developed cancer. None of the 86 cases with a D-score >1 (“favorable”) and one of the 20 (5%) cases with 0 < D-score ≤1 (“uncertain”) developed cancer. Sensitivity of the D-score was 100%, specificity 82%, the positive and negative predictive values were 38% and 100%, respectively. These values are similar to those in three prior retrospective D-score studies but higher than the WHO values (which are 91%, 58%, 16%, and 99%, respectively). The D-score in endometrial hyperplasias is a more sensitive and specific marker for cancer prediction than the WHO classification, can be assessed in a routine clinical setting on standard hematoxylin and eosin sections (15–30 minutes per case), and is highly reproducible and cost-effective (U.S. $50 per case).Keywords
This publication has 15 references indexed in Scilit:
- A Multicentric European Study Testing the Reproducibility of the WHO Classification of Endometrial Hyperplasia With a Proposal of a Simplified Working Classification for Biopsy and Curettage SpecimensThe American Journal of Surgical Pathology, 1999
- Reproducibility of the Diagnosis of Endometrial Hyperplasia, Atypical Hyperplasia, and Well-Differentiated CarcinomaThe American Journal of Surgical Pathology, 1998
- Use of computerized morphometric analyses of endometrial hyperplasias in the prediction of coexistent cancerAmerican Journal of Obstetrics and Gynecology, 1996
- The additional prognostic value of morphometric nuclear arrangement and DNA-ploidy to other morphometric and stereologic features in endometrial hyperplasiasInternational Journal of Gynecologic Cancer, 1994
- Assessment of the Risk on Endometrial Cancer in Hyperplasia, by Means of Morphological and Morphometrical FeaturesPathology - Research and Practice, 1992
- AnnouncementsGynecologic Oncology, 1989
- Architectural and nuclear morphometrical features together are more important prognosticators in endometrial hyperplasias than nuclear morphometrical features aloneThe Journal of Pathology, 1988
- Nuclear Morphometry in the Determination of the Prognosis of Marked Atypical Endometrial HyperplasiaInternational Journal of Gynecological Pathology, 1985
- The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patientsCancer, 1985
- Predicting the Outcome of Endometrial Hyperplasia by Quantitative Analysis of Nuclear Features Using a Linear Discriminant FunctionInternational Journal of Gynecological Pathology, 1983