Endometrial Intraepithelial Neoplasia And Its Correlation With WHO Classified Endometrial Hyperplasia

Abstract

Introduction: Endometrial hyperplasias are precursors of endometrial carcinoma. WHO hyperplasia classification system has confusing and overlapping criteria which prompted the development of a system based on Endometrial Intraepithelial Neoplasia (EIN). Objectives 1. To review Endometrial Intraepithelial Neoplasia. 2. To reclassify WHO classification of endometrial hyperplasia into EIN and non-EIN category. Materials And Methods: In 102 patients diagnosed as WHO hyperplasia reclassification was done using EIN criteria 1) Glandular crowding.2) Cytologic demarcation. 3) Size of the lesion should exceed 1mm. 4) exclude benign processes 5) exclude carcinoma. Results: Out of 102 cases, 53(51.96%) cases were diagnosed as simple typical hyperplasia, 12(11.76%) cases as complex typical hyperplasia, 21(20.58%) cases as simple atypical hyperplasia and 16(15.68%) cases as complex atypical hyperplasia. 26% were re-classified as EIN and 64% as non-EIN lesions. 23(62.16%) out of 37 cases of atypical hyperplasia were reclassified as EIN. None of the simple hyperplasias turned out to be EIN and 4(33.33%) of 12 cases of complex hyperplasia were reclassified as EIN. Conclusion: EIN criteria can be easily applied to routine haematoxylin and eosin sections and has good reproducibility. EIN diagnosis prevents the progression to endometrial adenocarcinoma and helps in clinical management which is less intensive than for adenocarcinoma.