A multivariate statistical study to obtain effective criteria to detect well-differentiated adenocarcinoma in endometrial cytology.
Consistency in endometrial cytology is relatively poor. This can be partly attributed to generally accepted criteria based on cellular features. The cytological distinction between grade-1 adenocarcinoma and endometrial hyperplasia is more reliant on architectural features than cellular features. We examined statistical criteria based on cytoarchitecture for detecting grade-1 adenocarcinoma in endometrial cytology. Histologically, the study population consisted of 11 cases of grade-1 adenocarcinoma, 6 of atypical endometrial hyperplasia, 16 of endometrial hyperplasia without atypia, and 74 of a normal proliferative endometrium. In each case, all cellclumps were divided into five patterns (tubular; sheet; dilated and/or branched tubular; regular overlapping; atypical). The frequencies of each pattern were submitted to five-variate cluster analysis. The validity and reproducibility of cluster analysis were tested by canonical discriminant analysis and multigroup linear discriminant analysis, respectively. All 107 cases were classified into three groups, A (11), B (36), and C (60), by five-variate cluster analysis. In comparison with this classification and histopathologic diagnosis, group A corresponded to adenocarcinoma, and groups B and C correlated with non-carcinoma. Most cases of atypical endometrial hyperplasia were included in group B. These data suggest that statistical groupings based on cytoarchitecture are useful in the discrimination of grade-1 adenocarcinoma from endometrial hyperplasia and normal tissue.
Department of Pathology, Fukuoka University, Chikushi Hospital, Chikushino, Japan. nmbmsm@minf.med.fukuoka-u.ac.jp
Masami
M
Nambu
Shinji
S
Matsumoto
Morishige
M
Takeshita
Kazuki
K
Nabeshima
Akinori
A
Iwashita
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology*; D002449:Cell Aggregation; D002454:Cell Differentiation; D016000:Cluster Analysis; D003581:Cytodiagnosis; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D015203:Reproducibility of Results