title: Fractal Dimension as a Diagnostic Tool of Complex Endometrial Hyperplasia and Well-differentiated Endometrioid Carcinoma.
abstract: OBJECTIVE
  Fractal dimension (FD) is widely used in medicine and biology as a tool for defining features of structure. This study aimed to compare pathological endometrium (simple-complex hyperplasia and endometrial carcinoma), as well as the endometrial changes, during the phases of the menstrual cycle. The main goal was the objective measurement of fractal dimension and to refrain from subjective evaluation.
  
  
  METHODS
  Two thousand cases of endometrial tissue from patients who underwent dilatation and curettage (D&C) were reviewed. Out of these, 137 cases were eligible for the study. In each case, immunohistochemistry with cytokeratin Ae1/AE3 was performed in order to simplify the evaluation of the FD.
  
  
  RESULTS
  Endometria with carcinoma, simple or complex hyperplasia showed significant differences only in the immunohistochemically stained fractal dimensions. As expected, significant differences were also found between atrophic and secretory endometrium and carcinoma.
  
  
  CONCLUSIONS
  FD is an objective, rapid and simple procedure for the differential diagnosis between complex hyperplasia and endometrial adenocarcinoma.
authors: "IASO" Maternity Hospital, Maroussi, Athens, Greece.
authors: Olga
authors: O
authors: Bikou
authors: 2ndOtolaryngology Department, "Attikon" University Hospital, The National and Kapodistrian University of Athens, Athens, Greece.
authors: Alexander
authors: A
authors: Delides
authors: "IASO" General Hospital, Athens, Greece.
authors: Aggeliki
authors: A
authors: Drougou
authors: Pathology Department, The National and Kapodistrian University of Athens, Athens, Greece.
authors: Afroditi
authors: A
authors: Nonni
authors: Pathology Department, The National and Kapodistrian University of Athens, Athens, Greece.
authors: Efstratios
authors: E
authors: Patsouris
authors: Pathology Department, The National and Kapodistrian University of Athens, Athens, Greece epavlaki@med.uoa.gr.
authors: Kitty
authors: K
authors: Pavlakis
mesh_terms: D017920:Antiporters / Q000378:metabolism; D018269:Carcinoma, Endometrioid / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D004714:Endometrial Hyperplasia / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D017709:Fractals; D006801:Humans
chemical_list: D017920:Antiporters; C489237:SLC4A3 protein, human
keywords: Fractal dimension; box counting; endometrium; hyperplasia