Histopathologic and nuclear morphometric characteristics of endometrial carcinomas

ABSTRACTEndometrial carcinoma is the most common gynecologic malignity in female genital system. Some current prognostic factors have been established in determining prognosis and planning treatment in endometrial carcinoma. Histological grading is one of the most important parameters of prognostic factors. In order to grade endometrial tumors histologically, a system recommended by FIGO which combines both structural and nuclear characteristics is used. In the recent years, methods based on quantitative morphometric measurements have been tried in order to minimize subjectiveassessments in determining histological grade. In this study, clinic, histopathologic characteristics and morphometric tumor cell nuclei measurements of endometriod carcinoma, acquired by using computer supported image analysis system were assessed. To investigate the relationship between nuclear grade, structural grade, last histologic grade and morphometric measurement results to both each other and every prognostic factor was aimed in the current review. 50 cases diagnosed with endometrioid type endometrial carcinoma at Bülent Ecevit University, Faculty of Medicine, Department ofPathology in between 2001-2011 were involved. All clinic data concerning the cases were collected from patient files. The preparations were re-examined without knowing clinic and pathologic diagnosis and every prognostic factor was re-determined by the same pathologist. For every case, 50 cell nuclei with a certain exterior border belonging to carcinoma regions were chosen, microscopic images of which were transferred to computers. After that, the same regions were examined with an image analysis program and nuclear area, the longest diameter, the shortest diameter and nuclear circumferencewere automatically measured. In two group comparison of normally distributed continuous variables; significance test of the difference between two means was used whereas in two group comparison of non-normally distributed variables Mann-Whitney U test was used. Pearson chi-square and Fischer certain chi-square tests were used to compare categorical variable groups. The relationship between measurement variables was checked with correlation analysis. There was a significant relationship between the nuclear grades and myometrial invasion depth, cervical and lenfovascular invasion, andalso between the structural and last histological grades and presence of squamous differentiation, myometrial invasion depth and lenfovascular invasion. There was a statistically significant relationship between the MNA (mean nuclear area), ML (mean length) and MC (mean circumference) and the structural and last histological grade of the cases. We failed to find a significant relationship between the MNA, ML, MC and MW (mean width) and other prognostic factors and nuclear grade. In conclusion, nuclear morphometric assessment was not found to be superior to subjective nuclear grading system. However, considering this system more time consuming and non practical; in larger series with additional and more detailed morphometric studies will reveal different results.Key words: Endometrioid adenocarcinoma, histologic grade, nuclear morphometry