Hysterectomy Specimens Research Articles

Evaluation of preoperative ultrasound signs associated with bladder injury during complex Cesarean delivery: case-control study.

Intraoperative hemorrhage and peripartum hysterectomy are the main complications in patients presenting with a low-lying placenta or placenta previa undergoing repeat Cesarean delivery (CD). Patients with a high probability of placenta accreta spectrum (PAS) at birth also have a higher risk of intraoperative urologic injury. The aim of this study was to evaluate the ultrasound signs and intraoperative features associated with these injuries. This was a retrospective case-control study of consecutive singleton pregnancies included in a prospective cohort of patients with a history of at least one prior CD and diagnosed prenatally with an anterior low-lying placenta or placenta previa at 32-36 weeks' gestation. All patients underwent investigational preoperative transabdominal and transvaginal ultrasound examination within 48 h prior to delivery. Ultrasound anomalies of uterine contour and uteroplacental vascularity, and gross anomalies of the lower uterine segment (LUS) and surrounding pelvic tissue at delivery, were recorded using a standardized protocol, which included evaluation of the extent of uterine contour anomalies. The diagnosis of PAS was established when one or more placental lobules could not be separated digitally from the uterine wall at delivery or during the gross examination of the hysterectomy or partial myometrial resection specimens, and was confirmed by histopathology. Data were compared between cases complicated by intraoperative bladder injury and controls from the same cohort matched at a 1:3 ratio by parity and the number of prior CDs using conditional logistic regression. There were 16 (9.4%) patients with an intraoperative bladder injury in a cohort of 170 managed by the same multidisciplinary team during the study period. There were no patients diagnosed with ureteric or bladder trigone damage. There were 14 (87.5%) patients with a bladder injury that had histopathologic evidence of PAS at birth, including 11 (68.8%) cases described on microscopic examination as placenta increta and three (18.8%) as placenta creta. There was a significant (P = 0.03) difference between cases and controls in the distribution of intraoperative LUS vascularity, whereby the higher the number of enlarged vessels, the higher the odds of bladder injury. Multivariable regression analysis revealed that both gestational age at delivery and LUS remodeling on transabdominal ultrasound were associated with bladder injury. A higher gestational age was associated with a lower risk of injury. A higher LUS remodeling grade on transabdominal ultrasound was associated with an increased risk of bladder injury. Patients with Grade-3 remodeling (involving > 50% of the LUS) had 9-times higher odds of a bladder injury compared to patients with Grade-1 remodeling (involving < 30% of the LUS). Preoperative ultrasound examination is useful in the evaluation of the risk of intraoperative bladder injury in patients with a history of prior CD presenting with a low-lying placenta or placenta previa. The larger the remodeling of the LUS on transabdominal ultrasound, the higher the risk of adverse urologic events. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

ASO Author Reflections: En Bloc Resection of Sentinel Lymph Nodes with the Hysterectomy Specimen in Endometrial Cancer.

ASO Author Reflections: En Bloc Resection of Sentinel Lymph Nodes with the Hysterectomy Specimen in Endometrial Cancer.

An occult leiomyosarcoma in a hysterectomy specimen presumed to be uterine fibroid preoperatively: A case report

An occult leiomyosarcoma in a hysterectomy specimen presumed to be uterine fibroid preoperatively: A case report

EnBloc Resection of Sentinel Lymph Nodes with the Hysterectomy Specimen in Endometrial Cancer.

We demonstrate the surgical technique of removing the sentinel lymph nodes with its afferent lymphatic vessels attached to the hysterectomy specimen. Stepwise demonstration of the technique with narrated video footage. Sentinel lymph node sampling has been established as an acceptable staging method in endometrial cancer cases.1 Lymphatic anatomy has been described according to three consistent channels for endometrial cancer dissemination: (1) an upper paracervical pathway draining external or obturator lymph nodes; (2) a lower pathway draining internal iliac lymph nodes; and (3) the infundibulo-pelvic pathway with a course along the broad ligament.2 A study in patients with cervical cancer identified tumor cells in the afferent lymphatic vessels of the upper pathway, even when the corresponding sentinel node was negative (3/20 patients).3 This could be an important prognostic factor in patients with cervical cancer. Since the typical position of sentinel nodes is the same in both endometrial and cervical cancers, we aimed to assess the feasibility of removing 'enbloc' the sentinel node with its afferent lymphatic vessels, and the uterus.4 INTERVENTIONS: The Da Vinci Xi surgical system was used. Indocyanine green was injected cervically, the pelvic surgical spaces were developed, and the sentinel lymph nodes, along with the afferent lymphatic vessels, were identified using the Firefly infrared camera. The lymphovascular tissue was mobilized and separated from the uterine artery, which was skeletonized and ligated. Colpotomy was performed and the specimen was retrieved vaginally. Emerging evidence regarding diagnosis, characterization, and treatment of endometrial cancer has introduced a new era, based on minimally invasive techniques for staging through sentinel lymph node biopsy, molecular classification, and personalized treatment algorithms that include immune checkpoint inhibitors and targeted therapies.5 Lymph node staging is one of the most significant prognostic factors in endometrial cancer patients and is a guide for adjuvant treatment. Sentinel lymph node biopsy is not inferior to conventional lymphadenectomy and is in fact a better way of identifying low-volume cancer through the use of ultrastaging, as part of the sentinel node algorithm.6 The dissection technique described in this video could offer an improvement in the staging of endometrial cancer, ensuring that the true sentinel lymph node is identified and that potential cancer cells inside the afferent lymphatic vessels are also excised. Therefore, it could be utilized as a more accurate way of planning adjuvant treatment and consequently improving recurrence and survival; however more studies are needed to further evaluate the feasibility and sensitivity of identifying disease in the afferent lymphatic vessels. This novel surgical technique emphasizes the importance of anatomical knowledge and offers inspiration for studies with potential clinical benefit that should follow.

A STUDY ON INDICATIONS, MODE OF HYSTERECTOMY AND HISTOPATHOLOGICAL ANALYSIS OF HYSTERECTOMY SPECIMENS

Objectives: To study the age distribution, indications, modes of hysterectomy, concurrent surgery done along with hysterectomy, and histopathological analysis of hysterectomized specimens. Methods: This study was conducted in the Department of Obstetrics and Gynecology, Mediciti Institute of Medical Sciences, a tertiary teaching hospital at Medchal. Medical records of 240 cases of hysterectomy performed from January 2015 to December 2021 were retrieved from the Medical Record Department. The age distribution, indications of hysterectomy, mode of hysterectomy, concurrent oophorectomy, and histopathological reports of hysterectomy specimens were analyzed in this study. Results: Out of the total 240 hysterectomies, 51.25% were in the age group of 40–49 years, followed by the age group of 50–59 years, i.e., 19.5%. Common indications for hysterectomy were AUB (36.25%), fibroids (34.58%), and UV prolapse (29.16%). Abdominal hysterectomy (62.5%) was performed more commonly than vaginal hysterectomy (29.16%). Histopathological analysis showed the most common pathologies as atrophic endometrium, leiomyoma in the myometrium, and inflammation in the cervix. Concurrent bilateral oophorectomy was done in 51.66%, unilateral oophorectomy was done in 10%, and ovaries were conserved in 38.33%. Conclusion: Hysterectomy is a common major gynecological surgery performed, most commonly in the perimenopausal age group. Although there is an increased trend toward the laparoscopic route, the abdominal route is still the preferred route. Leiomyoma is the most common pathology found in hysterectomized specimens. AUB being the most common indication for hysterectomy, there should be increased use of medical management, and patients should be counseled for conservative management in order to prevent increased surgical interventions.

PD-L1 Immunohistochemical Expression in Endometrial Carcinoma: Egyptian Cross-Sectional Study.

Endometrial carcinoma (EC) is the most common cancer of the female genital tract. According to the recently evolved strategies of cancer immunotherapy, immune checkpoints inhibitors are one of the most crucial strategies. Programmed Death Ligand 1 (PD-L1) is an important immune checkpoint regulator. PD-L1 antibodies have shown efficacy in clinical trials of some malignancies. Some of these antibodies have been approved for clinical usage by the Food and Drug Administration (FDA). This retrospective study included a total of 100 ECs, collected from archived, formalin-fixed, paraffin-embedded tissue blocks of hysterectomy specimens of Egyptian females. The samples were immunohistochemically analyzed for PD-L1 expression (in both tumor cells; TCs and tumor infiltrating leucocytes; TILs) by a semiquantitative score (0 to 4), with cutoff points of (0: <1% of the cells, 1: 1% to 4%, 2: 5% to 9%, 3: 10% to 49%, and 4: ≥ 50%). Membranous staining only was considered positive. PD-L1 was highly expressed in ECs (67% TCs+ and 61% TILs+), with statistically significant relationships with age, lympho-vascular space invasion (LVSI) and TILs score (P = 0.006, 0.016 and <0.005 respectively). However, no statistically significant relationships were detected between PD-L1 expression and the following parameters: histological type, histological grade, pathological stage (pT) or FIGO stage, myometrial, cervical, adnexal/serosal, parametrial involvements and nodal metastasis, as well as ESMO risk stratification system. Moreover, statistically significant relationships were achieved when correlating TILs score with tumor grade and LVSI (P = 0.034 and 0.012 respectively). Also, comparing endometrial hyperplasia (EH) PD-L1 and TCs PDL1 median scores achieved statistically significant relationship (P = 0.001). Our results concluded that PD-L1 expression was greater in both TCs and TILs in a subgroup of patients that have advanced age, LVSI and are TILs-rich, identifying them as potential candidates for anti-PD-1/PD-L1 immunotherapy.

Accuracy of endometrial sampling in the diagnosis of endometrial cancer: a multicenter retrospective analysis of the JAGO-NOGGO

BackgroundAccurate preoperative molecular and histological risk stratification is essential for effective treatment planning in endometrial cancer. However, inconsistencies between pre- and postoperative tumor histology have been reported in previous studies. To address this issue and identify risk factors related to inaccurate histologic diagnosis after preoperative endometrial evaluation, we conducted this retrospective analysis.MethodsWe conducted a retrospective analysis involving 375 patients treated for primary endometrial cancer in five different gynaecological departments in Germany. Histological assessments of curettage and hysterectomy specimens were collected and evaluated.ResultsPreoperative histologic subtype was confirmed in 89.5% of cases and preoperative tumor grading in 75.2% of cases. Higher rates of histologic subtype variations (36.84%) were observed for non-endometrioid carcinomas. Non-endometrioid (OR 4.41) histology and high-grade (OR 8.37) carcinomas were identified as predictors of diverging histologic subtypes, while intermediate (OR 5.04) and high grading (OR 3.94) predicted diverging tumor grading.ConclusionWhen planning therapy for endometrial cancer, the limited accuracy of endometrial sampling, especially in case of non-endometrioid histology or high tumor grading, should be carefully considered.

Vaginal Hysterectomy at the Time of Total Colpocleisis: A Single-Center Experience.

This study aims to evaluate the five-yearexperience of a single centerregarding the total colpocleisis procedure. This is a retrospective review of 24 women who underwent total colpocleisis at the study center between January 2017 and January 2023. Every participant was informed about this study, and written consent was obtained from each participant who then took Pelvic Floor Distress Inventory-20 (PFDI-20), Body Appreciation Scale-2 (BAS-2) and Decision Regret Scale (DRS) questionnaires consecutively. Eight patients (33.3%) underwent total colpocleisis, whereas 16 patients (66.7%) had concomitant colpocleisis and vaginal hysterectomy. The number of total colpocleisis cases did not change significantly with respect to the past years (p=0.117). The patients who underwent total colpocleisis and the patients who had concurrent colpocleisis and hysterectomy were statistically similar with respect to age, gravidity, chronic disease, blood group, American Society of Anesthesiologists classification, anesthesia type, surgery timing and preoperative and postoperative hemoglobin values (p>0.05 for all). Operative time was significantly shorter in patients who had colpocleisis alone (p=0.001). Both patient groups were also statistically similar in aspects of blood loss, transfusion need, hospital stay, postoperative complications and follow-up time as well as PFDI-20, BAS-2 and DRS scores (p>0.05 for all). Endometrial atrophy (56.3%), endometrial hyperplasia (18.8%) and adenomyosis (12.5%) were the most common histopathological findings detected in vaginal hysterectomy specimens. The combination of vaginal hysterectomy and total colpocleisis appears as a safe and efficient approach which does not contribute to the surgery-related morbidity despite the significantly longer operative time.

STUDY OF ENDOMETRIAL PATHOLOGY IN ABNORMAL UTERINE BLEEDING

Objective: Endometrial pathology is becoming the most common issue that affects women of reproductive age group worldwide. AUB encompasses a wide variety of presentations, for example, frequent menstrual cycles, frequent and heavy cyclical bleeding, irregular bleeding, and postcoital bleeding. This study was done to evaluate the endometrial causes of AUB and to determine the specific pathology in different age groups.&#x0D; Methods: This study was a prospective cross-sectional study conducted on 200 patients from January 2023 to October 2023 in the department of pathology in a reputed teaching hospital and research centre. All the endometrial biopsies/curretages and hysterectomy specimens sent for Histopathological examination with history of AUB were included in the study.&#x0D; Results: Age of the patients with AUB ranged from 17 to 71 y in our study. Out of 200 cases, 90 cases (45%) were seen in Perimenopausal group followed by 68 cases (34 %) in Reproductive age group and 42 cases (21%) in Postmenopausal age group. Menorrhagia was the most common bleeding pattern seen in 54% pf patient with AUB. In 28% in reproductive age group, hormonal imbalance was observed in 13% of reproductive age group and 6% in perimenopausal age group. Atrophic endometrium was observed in 7.5% of women in post-menopausal age group. Chronic endometritis was seen 3% of reproductive age group.&#x0D; Conclusion: Abnormal uterine bleeding in women belonging to different age group show variable endometrial pattern on histopathological examination. They are valuable in early detection of pre-cancerous endometrial lesions as well as malignancy.

Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer.

Magnetic resonance imaging (MRI) can be used for the preoperative local staging of endometrial cancer (EC). The presence of ≥pT1b disease (i.e., tumor invasion in ≥50% of the myometrium, into the cervical stroma or spread outside the uterus) has important prognostic value and implications for the decision to perform lymphadenectomy. The purpose of this study was to assess the performance of MRI for the detection of ≥pT1b disease and to evaluate whether tumor size measured via MRI was predictive for ≥pT1b disease, independent of imaging signs of deep invasion. MRI T-staging and tumor diameter and volume were correlated with histopathology of the hysterectomy specimen in 126 patients. MRI had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 70.0%, 83.3%, 79.2%, 75.3% and 77.0%, respectively, for the detection of ≥pT1b disease. A tumor diameter of ≥40 mm and volume of ≥20 mL measured via MRI were predictive for ≥pT1b disease at rates of 78.3% and 87.1%, respectively. An EC size of at least 5 mm upon MRI was predictive for ≥pT1b disease in more than 50% of cases. Our results support the use of MRI in the preoperative staging of EC and suggest including size criteria in EC staging guidelines.

Abstract PR002: Proteomic profiling of endometrial carcinomas

Abstract While endometrial cancer (EC) has an overall favorable prognosis, some patients do poorly and may benefit from refinements of current classification systems. The TCGA-inspired pragmatic molecular classification tool Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) has been integrated into international guidelines for EC risk stratification and management. ProMisE stratifies ECs into four prognostic groups: POLEmut, NSMP (no specific molecular profile), MMRd (mismatch repair deficient), and p53abn, where POLEmut has the best prognosis and p53abn has the worst prognosis. Our objective was to determine if proteomic profiling could provide additional prognostic or predictive information for EC patients, across or within ProMisE molecular subtypes. Global proteome profiling of FFPE samples, that had clinicopathologic and outcome data, was performed on 184 ECs encompassing all four ProMisE subtypes, including replicate samples of the same tumor, and both biopsy and final hysterectomy specimens. To ensure representation of each subtype, we aimed for an approximately equal distribution; 40 (27 %) MMRd, 33 (22 %) POLEmut, 42 (28 %) NSMP and 33 (22 %) p53abn, rather than the population-based distributions. There was high reproducibility in the proteomic profiles of intra-tumor replicate samples, and between matched biopsy and hysterectomy tumor samples (Pearson’s correlation &amp;gt;0.9). Consensus clustering generated four clusters, named ‘Adhesion’, ‘Immune’, ‘Proliferation’, and ‘Metabolic’ based on proteins enriched in each cluster. The Proliferation Cluster had the worst outcomes and the highest proportion of stage III/IV, serous, and p53abn tumors than the other clusters. The Immune Cluster had the most favorable outcomes, despite having a relatively substantial proportion of stage III/IV, serous, and p53abn tumors. We correlated protein expression with common mutations, including ARID1A mutations that cause loss of ARID1A protein expression, found in up to 60% ECs. ARID1A positive tumors also express proteins in the retinoic acid signaling pathway, while ARID1A-deficient tumors express proteins indicative of neutrophil infiltration. Comparing molecular subtypes, we found p53abn ECs were enriched in proteins associated with poor outcomes in many tumor types, such as GRB7. We validated elevated GRB7 expression in p53abn tumors using immunohistochemistry and found an association with worse disease specific survival (DSS) across the whole cohort (HR=2.39). Nucleolin expression was associated with worse prognosis in the NSMP subtype (DSS HR=9.88), while BABAM1 expression was associated with better prognosis within p53abn tumors (DSS HR=2.43). Knockout of BABAM1 (part of the BRCA complex) in cell lines resulted in increased sensitivity to PARP inhibition. Proteomic analysis of EC identifies candidate prognostic markers that may further refine current molecular classification and help guide treatment decisions. New therapeutic interventions could be developed to target proteins and pathways identified by EC proteomic profiling. Citation Format: Dawn R. Cochrane, Gian Luca Negri, Jutta Huvila, Juliana Sobral de Barros, Forouh Kalantari, Nissreen Mohammad, David Farnell, Emily Thompson, Amy Lum, Sandra E. Spencer, Amy Jamieson, Samuel Leung, Derek Chiu, Martin Koebel, Stefan Kommoss, Friedrich Kommoss, Blake Gilks, Lien Hoang, David Huntsman, Gregg B. Morin, Jessica N. McAlpine. Proteomic profiling of endometrial carcinomas [abstract]. In: Proceedings of the AACR Special Conference on Endometrial Cancer: Transforming Care through Science; 2023 Nov 16-18; Boston, Massachusetts. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(5_Suppl):Abstract nr PR002.

Residual cervical H-SIL after cervical conization with positive margins. Is there any associated risk factor?

Introduction: Cervical cancer is the second leading cause of death from gynecological cancer. In Argentina, it is estimated that nearly 4,500 new cases are diagnosed each year and 1,800 women die from this disease. The human papillomavirus (HPV) is a necessary but not a major cause to develop this type of cancer and it is responsible for producing both low-grade (L-SIL) and high-grade (H-SIL) squamous intraepithelial lesions (SIL) depending on the viral serotype in addition to other factors specific to the infected patient. Cervical intraepithelial neoplasia (CIN) is treated by local ablation or excision techniques with lower morbidity. The choice of treatment depends on the degree and extent of the disease, as well as the patient age, risk factors and immunity to generate spontaneous regression or persistence/recurrence. Objective: To identify clinical or pathological factors in patients who presented residual lesion (H-SIL) in the surgical specimens of both re-conization and hysterectomy (HT). Materials and methods: A retrospective, observational study was carried out at Sanatorio Güemes, Buenos Aires, Argentina. All patients that underwent cervical conization with an electric scalpel and had positive margins in the surgical specimen between January 2017 and May 2022 inclusive were analyzed. Data was obtained from 43 patients who had positive cervical conization specimen margins at our institution in the time period described above. Two patients who only had the exocervical margin involved and also 11 patients who did not meet the inclusion criteria were excluded. Among patients (30), all were reoperated (16 underwent re-conization, while in 14 patients it was decided to have a total hysterectomy). Among all the patients who underwent a new surgical procedure, residual disease was found in 10 patients (33.3%), while 20 patients (66.6%) had no residual lesion. Results: The highest percentage of patients (66.6%) did not present residual lesions in the posterior resection specimens. The parameter exhibiting the most substantial influence in our analysis was the proportion of lesion extension, exerting a significant effect on the persistence/recurrence of the disease in subsequent surgical samples (Relative Risk [RR] 7.87, 95% Confidence Interval [CI] 1.13-54.66, p &lt; 0.01). Conclusion: This information brings us even closer to the new reports of bibliographical data: although the presence of the compromised endocervical margin is valuable for estimating the risk of disease persistence/recurrence, it is not sufficient. Therefore, there is a lack of information about the importance of other factors to predict this situation.

Recurrence rates and patterns of recurrence in stage IA p53abn endometrial cancer with and without myometrial invasion

ObjectivesOptimal management of patients with stage IA p53abn endometrial cancer without myoinvasion, classified as intermediate risk in the 2020 European Society of Gynaecological Oncology, European Society for Radiotherapy and Oncology,...

Intrauterine manipulator use during laparoscopic hysterectomy for endometrial cancer: association for pathological factors and oncologic outcomes

ObjectiveTo examine the association between intrauterine manipulator use and pathological factors and oncologic outcomes in patients with endometrial cancer who had laparoscopic hysterectomy in Japan.MethodsThis was a nationwide retrospective cohort...

What are you looking for? An audit of the provided clinical information of 130 hysterectomy specimens

What are you looking for? An audit of the provided clinical information of 130 hysterectomy specimens

Adenosquamous Carcinoma of the Cervix - An Incidental Finding in the Hysterectomy Specimen of a Postmenopausal Female

Adenosquamous carcinoma of the cervix (ASCC) is a rare malignant histologic subtype that has well-defined malignant glandular and squamous components that can be recognized without special stains. Authors, hereby, describe a case of ASCC in a 68-year-old post-menopausal female who underwent hysterectomy for uterovaginal prolapse. A diffusely infiltrating growth involving both the lips of the cervix was seen on gross examination. Sections from the growth showed both malignant glandular and squamous components. ASCCs are rare and aggressive tumors; hence early detection and appropriate management is crucial for achieving favorable clinical outcomes.

Peritoneal mesometrial resection with lymphadenectomy following prior hysterectomy in intermediate/high-risk endometrial cancer: feasibility and safety

ObjectivePeritoneal mesometrial resection (PMMR) plus targeted compartmental lymphadenectomy (TCL) aims at removal of the locoregional cancer field in endometrial cancer (EC). Optimal locoregional control without adjuvant radiotherapy should be achieved concomitantly sparing systematic lymphadenectomy (LNE) for most of the patients. However, intermediate/high-risk EC is often definitely diagnosed postoperatively in simple hysterectomy specimen. Our aim was to evaluate feasibility and safety of a completing PMMR + TCL in patients following prior hysterectomy.MethodsWe evaluated data from 32 patients with intermediate/high-risk EC treated with PMMR + TCL or systematic pelvic and periaortic LNE following prior hysterectomy. Perioperative data on disease characteristics and morbidity were collected and patients were contacted for follow-up to determine the recurrence and survival status.ResultsWe report data from 32 patients with a mean follow-up of 31.7 months. The recurrence rate was 12.5% (4/32) without any isolated locoregional recurrences. Only 21.9% of patients received adjuvant radiotherapy. Rates of intra- and postoperative complications were 6.3% and 18.8%, respectively.ConclusionOur data suggest that robotic PMMR can be performed following prior hysterectomy when previously unknown risk factors arise, albeit with a moderate increase in morbidity. Moreover, despite a relevant reduction of adjuvant radiotherapy, follow-up data suggest an excellent locoregional control even without adjuvant radiotherapy.

Expression of Bcl-2 and Ki-67 in Endometrial Hyperplasia and Disordered Endometrium: A Cross-sectional Study

Introduction: Endometrial hyperplasia affects both premenopausal and postmenopausal women and is a pathological condition that ranges from mild, reversible glandular proliferations to direct precursors of cancer. B-cell Lymphoma 2 (Bcl-2), an antiapoptotic gene involved in the regulation of apoptosis, and Ki-67, a proliferation marker, serve as indicators for cell proliferation from endometrial hyperplasia to endometrial carcinoma. Aim: To examine the expression of Bcl-2 and Ki-67 in endometrial hyperplasia and disordered endometrium. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology at MVJ Medical College and Research Hospital, located in Hoskote, Karnataka, India, over a period of two years, from September 2020 to September 2022. All endometrial samples and hysterectomy specimens were included. Immunohistochemical staining was performed using Bcl-2 and Ki-67 in disordered proliferative endometrium and endometrial hyperplasia, and the staining and intensity were graded. Statistical analysis was performed, with qualitative variables presented as percentages and quantitative variables presented as Mean±Standard Deviation (SD). A p-value &lt;0.05 was considered statistically significant. Results: The mean age of the study participants was 49.36 years. A total of 33 cases were included in the study, with 15 cases of disordered proliferative endometrium and 18 cases of endometrial hyperplasia. Bcl-2 expression in the 15 cases of disordered proliferative endometrium showed a score 4 positivity in 2 (13.3%) cases, score 8 positivity in 3 (20%) cases, and score 12 positivity in 10 (66.7%) cases, with a mean score of 10.13. Ki-67 expression in the 15 cases of disordered proliferative endometrium showed a score 4 positivity in 10 cases (66.7%), score 8 positivity in 4 (26.7%), and score 12 positivity in 1 (6.67%) case, with a mean score of 5.6. Conclusion: The overexpression of Bcl-2 in endometrial hyperplasia is considered to be an indicative of progression towards frank malignancy. Ki-67, the proliferation marker, is used to determine the progression of endometrial hyperplasia to carcinoma.

Histopathological analysis of hysterectomy specimens in tertiary care center

Histopathological analysis of hysterectomy specimens in tertiary care center

Histopathological analysis of gynaecological hysterectomy specimens at a tertiary care hospital in southern Nigeria

Histopathological analysis of gynaecological hysterectomy specimens at a tertiary care hospital in southern Nigeria