Karyometry in atypical endometrial hyperplasia: A Gynecologic Oncology Group study

Peter H. Bartels, Francisco A Garcia, Cornelia L. Trimble, James Kauderer, John Curtin, Peter C. Lim, Lisa M. Hess, Steven Silverberg, Richard J. Zaino, Michael Yozwiak, Hubert G. Bartels, David S Alberts

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: Treatment for atypical endometrial hyperplasia (AEH) is based on pathologic diagnosis. About 40% of AEH is found to be carcinoma at surgery. This study's objective is to derive an objective characterization of nuclei from cases diagnosed as AEH or superficially invasive endometrial cancer (SIEC). Methods: Cases from GOG study 167A were classified by a central pathology committee as AEH (n = 39) or SIEC (n = 39). High resolution digitized images of cell nuclei were recorded. Features of the nuclear chromatin pattern were computed. Classification rules were derived by discriminant analysis. Results: Nuclei from cases of AEH and SIEC occupy the same range on a progression curve for endometrial lesions. Cases of AEH and SIEC both comprise nuclei of two phenotypes: hyperplastic characteristics and premalignant/neoplastic characteristics. The principal difference between AEH and SIEC is the percentage of premalignant/neoplastic nuclei. When this percentage approaches 50-60% superficial invasion is likely. SIEC may develop already from lesions at the low end of the progression curve. Conclusions: AEH comprises cases which may constitute a low risk group involving < 40% of AEH cases. These cases hold a percentage of < 20% of nuclei of a preneoplastic phenotype. AEH cases from the central and high end of progression have > 40% of nuclei of preneoplastic phenotype. Nuclei of the preneoplastic phenotype in AEH lesions are almost indistinguishable from nuclei in SIEC, where this percentage exceeds 60%. The percentage of nuclei of the preneoplastic phenotype in AEH esions might serve as criterion for assessment of risk for the development of invasive disease.

Original languageEnglish (US)
Pages (from-to)129-135
Number of pages7
JournalGynecologic Oncology
Volume125
Issue number1
DOIs
StatePublished - Apr 2012

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Karyometry
Endometrial Hyperplasia
Endometrial Neoplasms
Phenotype
Discriminant Analysis
Cell Nucleus
Chromatin

Keywords

  • Atypical endometrial hyperplasia
  • Endometrial cancer
  • Karyometry
  • Risk stratification

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Karyometry in atypical endometrial hyperplasia : A Gynecologic Oncology Group study. / Bartels, Peter H.; Garcia, Francisco A; Trimble, Cornelia L.; Kauderer, James; Curtin, John; Lim, Peter C.; Hess, Lisa M.; Silverberg, Steven; Zaino, Richard J.; Yozwiak, Michael; Bartels, Hubert G.; Alberts, David S.

In: Gynecologic Oncology, Vol. 125, No. 1, 04.2012, p. 129-135.

Research output: Contribution to journalArticle

Bartels, PH, Garcia, FA, Trimble, CL, Kauderer, J, Curtin, J, Lim, PC, Hess, LM, Silverberg, S, Zaino, RJ, Yozwiak, M, Bartels, HG & Alberts, DS 2012, 'Karyometry in atypical endometrial hyperplasia: A Gynecologic Oncology Group study', Gynecologic Oncology, vol. 125, no. 1, pp. 129-135. https://doi.org/10.1016/j.ygyno.2011.12.422
Bartels, Peter H. ; Garcia, Francisco A ; Trimble, Cornelia L. ; Kauderer, James ; Curtin, John ; Lim, Peter C. ; Hess, Lisa M. ; Silverberg, Steven ; Zaino, Richard J. ; Yozwiak, Michael ; Bartels, Hubert G. ; Alberts, David S. / Karyometry in atypical endometrial hyperplasia : A Gynecologic Oncology Group study. In: Gynecologic Oncology. 2012 ; Vol. 125, No. 1. pp. 129-135.
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abstract = "Objectives: Treatment for atypical endometrial hyperplasia (AEH) is based on pathologic diagnosis. About 40{\%} of AEH is found to be carcinoma at surgery. This study's objective is to derive an objective characterization of nuclei from cases diagnosed as AEH or superficially invasive endometrial cancer (SIEC). Methods: Cases from GOG study 167A were classified by a central pathology committee as AEH (n = 39) or SIEC (n = 39). High resolution digitized images of cell nuclei were recorded. Features of the nuclear chromatin pattern were computed. Classification rules were derived by discriminant analysis. Results: Nuclei from cases of AEH and SIEC occupy the same range on a progression curve for endometrial lesions. Cases of AEH and SIEC both comprise nuclei of two phenotypes: hyperplastic characteristics and premalignant/neoplastic characteristics. The principal difference between AEH and SIEC is the percentage of premalignant/neoplastic nuclei. When this percentage approaches 50-60{\%} superficial invasion is likely. SIEC may develop already from lesions at the low end of the progression curve. Conclusions: AEH comprises cases which may constitute a low risk group involving < 40{\%} of AEH cases. These cases hold a percentage of < 20{\%} of nuclei of a preneoplastic phenotype. AEH cases from the central and high end of progression have > 40{\%} of nuclei of preneoplastic phenotype. Nuclei of the preneoplastic phenotype in AEH lesions are almost indistinguishable from nuclei in SIEC, where this percentage exceeds 60{\%}. The percentage of nuclei of the preneoplastic phenotype in AEH esions might serve as criterion for assessment of risk for the development of invasive disease.",
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T2 - A Gynecologic Oncology Group study

AU - Bartels, Peter H.

AU - Garcia, Francisco A

AU - Trimble, Cornelia L.

AU - Kauderer, James

AU - Curtin, John

AU - Lim, Peter C.

AU - Hess, Lisa M.

AU - Silverberg, Steven

AU - Zaino, Richard J.

AU - Yozwiak, Michael

AU - Bartels, Hubert G.

AU - Alberts, David S

PY - 2012/4

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N2 - Objectives: Treatment for atypical endometrial hyperplasia (AEH) is based on pathologic diagnosis. About 40% of AEH is found to be carcinoma at surgery. This study's objective is to derive an objective characterization of nuclei from cases diagnosed as AEH or superficially invasive endometrial cancer (SIEC). Methods: Cases from GOG study 167A were classified by a central pathology committee as AEH (n = 39) or SIEC (n = 39). High resolution digitized images of cell nuclei were recorded. Features of the nuclear chromatin pattern were computed. Classification rules were derived by discriminant analysis. Results: Nuclei from cases of AEH and SIEC occupy the same range on a progression curve for endometrial lesions. Cases of AEH and SIEC both comprise nuclei of two phenotypes: hyperplastic characteristics and premalignant/neoplastic characteristics. The principal difference between AEH and SIEC is the percentage of premalignant/neoplastic nuclei. When this percentage approaches 50-60% superficial invasion is likely. SIEC may develop already from lesions at the low end of the progression curve. Conclusions: AEH comprises cases which may constitute a low risk group involving < 40% of AEH cases. These cases hold a percentage of < 20% of nuclei of a preneoplastic phenotype. AEH cases from the central and high end of progression have > 40% of nuclei of preneoplastic phenotype. Nuclei of the preneoplastic phenotype in AEH lesions are almost indistinguishable from nuclei in SIEC, where this percentage exceeds 60%. The percentage of nuclei of the preneoplastic phenotype in AEH esions might serve as criterion for assessment of risk for the development of invasive disease.

AB - Objectives: Treatment for atypical endometrial hyperplasia (AEH) is based on pathologic diagnosis. About 40% of AEH is found to be carcinoma at surgery. This study's objective is to derive an objective characterization of nuclei from cases diagnosed as AEH or superficially invasive endometrial cancer (SIEC). Methods: Cases from GOG study 167A were classified by a central pathology committee as AEH (n = 39) or SIEC (n = 39). High resolution digitized images of cell nuclei were recorded. Features of the nuclear chromatin pattern were computed. Classification rules were derived by discriminant analysis. Results: Nuclei from cases of AEH and SIEC occupy the same range on a progression curve for endometrial lesions. Cases of AEH and SIEC both comprise nuclei of two phenotypes: hyperplastic characteristics and premalignant/neoplastic characteristics. The principal difference between AEH and SIEC is the percentage of premalignant/neoplastic nuclei. When this percentage approaches 50-60% superficial invasion is likely. SIEC may develop already from lesions at the low end of the progression curve. Conclusions: AEH comprises cases which may constitute a low risk group involving < 40% of AEH cases. These cases hold a percentage of < 20% of nuclei of a preneoplastic phenotype. AEH cases from the central and high end of progression have > 40% of nuclei of preneoplastic phenotype. Nuclei of the preneoplastic phenotype in AEH lesions are almost indistinguishable from nuclei in SIEC, where this percentage exceeds 60%. The percentage of nuclei of the preneoplastic phenotype in AEH esions might serve as criterion for assessment of risk for the development of invasive disease.

KW - Atypical endometrial hyperplasia

KW - Endometrial cancer

KW - Karyometry

KW - Risk stratification

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