title: Search for problem areas in endometrial biopsies to achieve quality assurance.
abstract: The aim of this study was to underline the frequently seen problems in diagnosing the lesions seen in the hyperplasia-carcinoma sequence by evaluating the variances between the observers. Four pathologists re-evaluated 137 endometrial biopsies and grouped them into diagnostic categories. The results were analyzed by Kappa statistics. Full agreement was reached in 89 cases (64.96%), with Kappa values ranging between 0.63-0.74. Three observers rendered the same diagnosis in 34 (24.81%) cases, and only one pathologist disagreed. Two or more observers held different views in 16 cases (10.95%). The problem areas were as follows: criteria distinguishing simple hyperplasia from other benign lesions, discrimination between atypical hyperplasia and carcinoma, and decision-making regarding the presence of atypia. There was a tendency towards overdiagnosis of hyperplasia in our department. Since the progression to carcinoma is a sequential event, borderline cases will exist if categories based on simple and clear cut off points are not defined.
authors.affiliation: Hacettepe University, School of Medicine, Department of Pathology, Ankara, Turkey. usubutun@ato.org.tr
authors.forename: A
authors.initials: A
authors.lastname: Usubütün
authors.forename: D
authors.initials: D
authors.lastname: Ertoy
authors.forename: O
authors.initials: O
authors.lastname: Ozkaya
authors.forename: G
authors.initials: G
authors.lastname: Altinok
authors.forename: T
authors.initials: T
authors.lastname: Kücukali
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D001706:Biopsy; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D004714:Endometrial Hyperplasia / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results