Endometrial biopsy: a karyometric and stereological study

Area of Science:

• Pathology
• Histology
• Stereology

Background:

• Diagnosing premalignant endometrial lesions presents challenges for pathologists.
• The D-score system offers improved reproducibility over the WHO scheme but lacks widespread availability.
• This study introduces a custom workstation for estimating the D-score.

Purpose of the Study:

• To develop and validate a simple, custom-made workstation for estimating the D-score.
• To assess the feasibility of using stereologic and morphometric principles for D-score calculation.
• To provide a more accessible and reproducible method for diagnosing endometrial lesions.

Main Methods:

• Analysis of 15 hyperplastic, 15 proliferative, and 8 secretory phase endometria using light microscopy and stereology.
• Determination of glandular and stromal volume and surface density.
• Estimation of karyometric parameters of endometrial glandular epithelial cells, including nuclear shape and contour.
• Calculation of the D-score based on architectural and karyometric features.

Main Results:

• Significant differences in stromal volume (VPS) were observed between proliferative, secretory, and hyperplastic endometria.
• Nuclear shape analysis revealed significant differences in the ratio of longest to shortest nuclear axis, shape factor, and contour index between endometrial phases.
• 67% of hyperplastic endometria exhibited D-score values below 0, indicating potential for differentiation.

Conclusions:

• A semi-automated workstation based on stereologic and morphometric principles can feasibly estimate the D-score.
• This approach offers a promising, reproducible method for diagnosing premalignant endometrial lesions.
• The custom workstation enhances diagnostic accuracy and accessibility in pathology.