title: DNA ploidy and S-phase fraction analyses of hyperplastic, atypical and cancerous endometrium using flow cytometry from paraffin-embedded tissues.
abstract: Atypical hyperplasia of the endometrium is an entity that needs to be clearly distinguished from other florid hyperplastic states on the one hand and from well-differentiated adenocarcinomas on the other. This may at times be difficult on pure morphological grounds. In this study, DNA ploidy and S-phase fraction of hyperplastic, atypical and cancerous endometrium were evaluated using flow cytometry from paraffin-embedded tissues. In total, 72 cases (24 hyperplastic, 24 atypical and 24 adenocarcinomas) were selected. All hyperplastic endometria showed a diploid stemline, while 2/24 atypical hyperplasias showed aneuploid (Near-diploid) peaks. Both of these cases were severely atypical and one of these, on hysterectomy, showed early invasive carcinoma. There was no significant difference in mean S-phase fractions of hyperplastic vs. atypical endometria. DNA aneuploidy was significantly more common with much higher S-phase fractions in poorly and moderately differentiated carcinomas than in well-differentiated ones. It was concluded that aneuploid (near-diploid) peaks, if ever present in atypical hyperplasias, may indicate an aggressive disease/neoplastic transformation.
authors.affiliation: Department of Pathology, The Aga Khan University Hospital Karachi, Pakistan. shahid.pervez@aku.edu
authors.forename: S
authors.initials: S
authors.lastname: Pervez
authors.forename: A
authors.initials: A
authors.lastname: Hitchcock
authors.forename: T M
authors.initials: TM
authors.lastname: Sinton
authors.forename: A
authors.initials: A
authors.lastname: Mani
authors.forename: J L
authors.initials: JL
authors.lastname: Smith
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology; D000236:Adenoma / Q000235:genetics / Q000473:pathology; D004273:DNA, Neoplasm / Q000032:analysis*; D004714:Endometrial Hyperplasia / Q000235:genetics* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000235:genetics* / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016612:Paraffin Embedding; D011003:Ploidies; D011230:Precancerous Conditions / Q000235:genetics* / Q000473:pathology; D016196:S Phase
chemical_list: D004273:DNA, Neoplasm