Contribution of nuclear morphometric features to differentiation of atypical complex type endometrial hyperplasia and low grade endometrial carcinoma

Abstract

Objective: The differentiation of atypical complex type endometrial hyperplasia (ACEH) and low grade endometrial carcinoma (EC) may be problematic in endometrial biopsy materials. Desmoplasia and stromal invasion are diagnostic for EC but they are not always demonstrated in endometrial biopsies. In this study, we investigated the contribution of nuclear morphometry to distinction of ACEH and low grade EC. Methods: Ten low grade EC and eight ACEH cases retrieved from the archives of the Department of Pathology. For each case at least 100 nuclei (totally 1000 for both groups) were selected using hematoxylen-eosine stained sections and evaluated by a computer assisted system. Measured nuclear morphometric features were nuclear area, nuclear perimeter, circular form factor, diameter equivalent circle, minimum feret, maximum feret, area convex hull, perimeter convex hull. Results: There was no significant differences between these two groups for circular form factor (P=0.871). But all other morphometric features were statistically significant (P<0.05). Conclusion: Our findings suggest that nuclear morphometric features may be used as an ancillary diagnostic tool in addition to conventional histopathological findings in borderline lesion. These findings should be confirmed with expanded case series.