Ayşe Nur Uğur KILINÇ, Sıdıka FINDIK, Pembe OLTULU

Endometrial Hiperplazi ve Karsinomunda Nükleus Boyutunun Karşılaştırmalı Morfometrik Analizi

Amaç: Ülkemizde ve tüm dünyada sıklığı giderek artmakta olan endometrial karsinomların öncül lezyonları endometrial hiperplazilerdir. Histopatolojik özellikleri tanımlanmış olmasına rağmen kriterlerin objektif olmaması ve immünohistokimyasal tekniklerin sınırlı olması hiperplazi olgularında gözlemciler arasında uyumsuzluk ortaya çıkarmaktadır. Çalışmamızda atipili ve atipisiz endometrial hiperplazi ile atipili hiperplazi (EİN) ve Grade-I karsinomlarda gland epitel hücrelerinde en kısa nukleus çapı (NKÇ) ölçülerek gözlemciler arasındaki varyasyonlarını en aza indirmek için tanıya yardımcı olabilecek farklılık ve oran bulmayı amaçladık. Materyal ve Metot: Çalışmamıza; küretaj ve histerektomi materyallerinde proliferatif endometrium, endometrial hiperplazi ve adenokarsinom tanısı almış 100 vaka dahil edildi. Her bir olguda 50 adet gland epitel hücresi nükleuslarının en kısa çapı görüntü analiz programı ile (BAB Bs200Pro Image Analysis Software) manuel olarak ölçüldü. Bulgular: İkili grupların karşılaştırılmasında EİN'in glandüler epitel NKÇ’si ile atipik hiperplazi (AH)'nin glandüler epitel NKÇ’si, AH'nin glandüler epitel NKÇ'si ile proliferatif endometirum (PE)'nin glandüler epitel NKÇ'si arasındaki karşılaştırmalar dışında, tüm ikili karşılaştırmalarda istatistiksel olarak anlamlı derecede farklılık bulunmuştur (p <0,01). Sonuç: Çalışmamızda ortaya çıkan nükleus çapları ile ilgili oran ve kıyaslamaların rutin ışık mikroskobu ile histopatolojik incelemede ilave ekipman gerekmeden öngörülerde bulunduğu için pratik uygulamalarda faydalı olabileceğini düşünüyoruz.

Anahtar Kelimeler:

endometrial hiperplazi, morfometrik analiz, endometrial intraepitelyal neoplazi

Comparative Morphometric Analysis of Nucleus Size in Endometrial Hyperplasia and Carcinoma

Objective: Endometrial hyperplasias are the preliminary lesions of endometrial carcinomas. Although the histopathologic features are well-defined, the criteria are not objective and the immunohistochemical techniques are limited, resulting in inconsistency between the observers in cases of hyperplasia. Our study aimed to measure and compare the shortest nuclear diameter (SND) of gland epithelial cells; to find differences and ratios that may help to minimize variations among observers. Materials and Methods: Our study included 100 cases diagnosed as proliferative endometrium (PE), endometrial hyperplasia, and endometrioid carcinoma from their curettage and hysterectomy materials. For each case, the shortest diameter of 50 gland epithelial cell nuclei was manually measured with an image analysis program (BAB Bs200 Pro Image Analysis Software). Results: Comparison of binary groups revealed that except the comparisons between glandular epithelial SNDM of EIN (endometrial intraepithelial neoplasia) and glandular epithelial SNDM of AH (atypical hyperplasia), and glandular epithelial SNDM of AH and glandular epithelial SNDM of PE all comparisons were statistically significantly different (p<0.01). Conclusion: We think that the ratios and comparisons related to nucleus diameters obtained in our study may be useful in practical applications because predictions can be made with routine light microscopy and histopathological examination.

Keywords:

endometrial hyperplasia , morphometric analysis, endometrial intraepithelial neoplasia,

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