endometrial biopsy: a karyometric and stereological study

Background: Diagnosis of premalignant endometrial lesions is a major challenge to pathologists. The D-score system is more reproducible than the WHo scheme, however it is not widely available, this study attest a simple custom-made workstation for estimation of the "D-score". Material and methods: Fifteen endometriam with low grade hyperplasia, fifteen proliferative and eight secretory phase endometria were analyzed by light microscopy and stereology. We determined the volume and surface density glands & stroma. karyometric parameters of the endometrial glandular epithelial cells were estimated. D-score was calculated from some architectural & karyometric parameters. Re¬sults: The volume of stroma (VPS) was signifi¬cantly higher in proliferative than secretory and hyperplastic endometria. The glandular surface density were higher in secretory endometria than proliferative and hyperplas¬tic endometria, however, the differences was statistically insignificant. The ratio of longest nuclear axis to shortest nuclear axis was significantly less in secretory than proliferative and hyperplastic endometria. Secretory endometria also have significantly lower mean values of shape factor & signifi¬cantly higher mean values of contour index than proliferative and secretory endometria. 67% of hyperplastic endometria show D-score values < 0. Conclusion: it seems feasible to estimate D-score using a semi-automated workstation based on the simple stereologic and morphometric principles.