Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias

Jan P A Baak, Anne Ørbo, Paul J. Van Diest, Mehdi Jiwa, Peter De Bruin, Marc Broeckaert, Wim Snijders, P. Jan Boodt, Guus Fons, Curt Burger, Renee H M Verheijen, Paul W H Houben, H. Sien The, Peter Kenemans

Research output: Contribution to journalArticle

Abstract

Prospective multicenter evaluation of the WHO classification and the morphometric D-score to predict endometrial hyperplasia cancer progression. In 132 endometrial hyperplasias WHO classification was performed by two experienced gynecologic pathologists. The D-score was assessed blindly by technicians in a routine diagnostic setting. Development of endometrial carcinoma during a 1-10-year follow-up was used as the end point. Eleven of 132 patients (8%), 10 of 61 (16%) atypical hyperplasias, and 1 of 71 (1%) nonatypical hyperplasias developed cancer. Twenty-six curettings had a D-score ≤0 ("unfavorable" or endometrial intraepithelial neoplasia) of which 10 (38%) developed cancer. None of the 86 cases with a D-score >1 ("favorable") and one of the 20 (5%) cases with 0 <D-score ≤1 ("uncertain") developed cancer. Sensitivity of the D-score was 100%, specificity 82%, the positive and negative predictive values were 38% and 100%, respectively. These values are similar to those in three prior retrospective D-score studies but higher than the WHO values (which are 91%, 58%, 16%, and 99%, respectively). The D-score in endometrial hyperplasias is a more sensitive and specific marker for cancer prediction than the WHO classification, can be assessed in a routine clinical setting on standard hematoxylin and eosin sections (15-30 minutes per case), and is highly reproducible and cost-effective (U.S. $50 per case).

Original languageEnglish (US)
Pages (from-to)930-935
Number of pages6
JournalAmerican Journal of Surgical Pathology
Volume25
Issue number7
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Endometrial Hyperplasia
Neoplasms
Endometrial Neoplasms
Hyperplasia
Hematoxylin
Eosine Yellowish-(YS)
Costs and Cost Analysis

Keywords

  • Endometrium
  • Hyperplasia
  • Morphometry
  • Progression
  • WHO

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias. / Baak, Jan P A; Ørbo, Anne; Van Diest, Paul J.; Jiwa, Mehdi; De Bruin, Peter; Broeckaert, Marc; Snijders, Wim; Boodt, P. Jan; Fons, Guus; Burger, Curt; Verheijen, Renee H M; Houben, Paul W H; The, H. Sien; Kenemans, Peter.

In: American Journal of Surgical Pathology, Vol. 25, No. 7, 2001, p. 930-935.

Research output: Contribution to journalArticle

Baak, JPA, Ørbo, A, Van Diest, PJ, Jiwa, M, De Bruin, P, Broeckaert, M, Snijders, W, Boodt, PJ, Fons, G, Burger, C, Verheijen, RHM, Houben, PWH, The, HS & Kenemans, P 2001, 'Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias', American Journal of Surgical Pathology, vol. 25, no. 7, pp. 930-935. https://doi.org/10.1097/00000478-200107000-00012
Baak, Jan P A ; Ørbo, Anne ; Van Diest, Paul J. ; Jiwa, Mehdi ; De Bruin, Peter ; Broeckaert, Marc ; Snijders, Wim ; Boodt, P. Jan ; Fons, Guus ; Burger, Curt ; Verheijen, Renee H M ; Houben, Paul W H ; The, H. Sien ; Kenemans, Peter. / Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias. In: American Journal of Surgical Pathology. 2001 ; Vol. 25, No. 7. pp. 930-935.
@article{8b35c198ab3e42b2b5891e4dfc27958b,
title = "Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias",
abstract = "Prospective multicenter evaluation of the WHO classification and the morphometric D-score to predict endometrial hyperplasia cancer progression. In 132 endometrial hyperplasias WHO classification was performed by two experienced gynecologic pathologists. The D-score was assessed blindly by technicians in a routine diagnostic setting. Development of endometrial carcinoma during a 1-10-year follow-up was used as the end point. Eleven of 132 patients (8{\%}), 10 of 61 (16{\%}) atypical hyperplasias, and 1 of 71 (1{\%}) nonatypical hyperplasias developed cancer. Twenty-six curettings had a D-score ≤0 ({"}unfavorable{"} or endometrial intraepithelial neoplasia) of which 10 (38{\%}) developed cancer. None of the 86 cases with a D-score >1 ({"}favorable{"}) and one of the 20 (5{\%}) cases with 0 <D-score ≤1 ({"}uncertain{"}) developed cancer. Sensitivity of the D-score was 100{\%}, specificity 82{\%}, the positive and negative predictive values were 38{\%} and 100{\%}, respectively. These values are similar to those in three prior retrospective D-score studies but higher than the WHO values (which are 91{\%}, 58{\%}, 16{\%}, and 99{\%}, respectively). The D-score in endometrial hyperplasias is a more sensitive and specific marker for cancer prediction than the WHO classification, can be assessed in a routine clinical setting on standard hematoxylin and eosin sections (15-30 minutes per case), and is highly reproducible and cost-effective (U.S. $50 per case).",
keywords = "Endometrium, Hyperplasia, Morphometry, Progression, WHO",
author = "Baak, {Jan P A} and Anne {\O}rbo and {Van Diest}, {Paul J.} and Mehdi Jiwa and {De Bruin}, Peter and Marc Broeckaert and Wim Snijders and Boodt, {P. Jan} and Guus Fons and Curt Burger and Verheijen, {Renee H M} and Houben, {Paul W H} and The, {H. Sien} and Peter Kenemans",
year = "2001",
doi = "10.1097/00000478-200107000-00012",
language = "English (US)",
volume = "25",
pages = "930--935",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias

AU - Baak, Jan P A

AU - Ørbo, Anne

AU - Van Diest, Paul J.

AU - Jiwa, Mehdi

AU - De Bruin, Peter

AU - Broeckaert, Marc

AU - Snijders, Wim

AU - Boodt, P. Jan

AU - Fons, Guus

AU - Burger, Curt

AU - Verheijen, Renee H M

AU - Houben, Paul W H

AU - The, H. Sien

AU - Kenemans, Peter

PY - 2001

Y1 - 2001

N2 - Prospective multicenter evaluation of the WHO classification and the morphometric D-score to predict endometrial hyperplasia cancer progression. In 132 endometrial hyperplasias WHO classification was performed by two experienced gynecologic pathologists. The D-score was assessed blindly by technicians in a routine diagnostic setting. Development of endometrial carcinoma during a 1-10-year follow-up was used as the end point. Eleven of 132 patients (8%), 10 of 61 (16%) atypical hyperplasias, and 1 of 71 (1%) nonatypical hyperplasias developed cancer. Twenty-six curettings had a D-score ≤0 ("unfavorable" or endometrial intraepithelial neoplasia) of which 10 (38%) developed cancer. None of the 86 cases with a D-score >1 ("favorable") and one of the 20 (5%) cases with 0 <D-score ≤1 ("uncertain") developed cancer. Sensitivity of the D-score was 100%, specificity 82%, the positive and negative predictive values were 38% and 100%, respectively. These values are similar to those in three prior retrospective D-score studies but higher than the WHO values (which are 91%, 58%, 16%, and 99%, respectively). The D-score in endometrial hyperplasias is a more sensitive and specific marker for cancer prediction than the WHO classification, can be assessed in a routine clinical setting on standard hematoxylin and eosin sections (15-30 minutes per case), and is highly reproducible and cost-effective (U.S. $50 per case).

AB - Prospective multicenter evaluation of the WHO classification and the morphometric D-score to predict endometrial hyperplasia cancer progression. In 132 endometrial hyperplasias WHO classification was performed by two experienced gynecologic pathologists. The D-score was assessed blindly by technicians in a routine diagnostic setting. Development of endometrial carcinoma during a 1-10-year follow-up was used as the end point. Eleven of 132 patients (8%), 10 of 61 (16%) atypical hyperplasias, and 1 of 71 (1%) nonatypical hyperplasias developed cancer. Twenty-six curettings had a D-score ≤0 ("unfavorable" or endometrial intraepithelial neoplasia) of which 10 (38%) developed cancer. None of the 86 cases with a D-score >1 ("favorable") and one of the 20 (5%) cases with 0 <D-score ≤1 ("uncertain") developed cancer. Sensitivity of the D-score was 100%, specificity 82%, the positive and negative predictive values were 38% and 100%, respectively. These values are similar to those in three prior retrospective D-score studies but higher than the WHO values (which are 91%, 58%, 16%, and 99%, respectively). The D-score in endometrial hyperplasias is a more sensitive and specific marker for cancer prediction than the WHO classification, can be assessed in a routine clinical setting on standard hematoxylin and eosin sections (15-30 minutes per case), and is highly reproducible and cost-effective (U.S. $50 per case).

KW - Endometrium

KW - Hyperplasia

KW - Morphometry

KW - Progression

KW - WHO

UR - http://www.scopus.com/inward/record.url?scp=0034956638&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034956638&partnerID=8YFLogxK

U2 - 10.1097/00000478-200107000-00012

DO - 10.1097/00000478-200107000-00012

M3 - Article

VL - 25

SP - 930

EP - 935

JO - American Journal of Surgical Pathology

JF - American Journal of Surgical Pathology

SN - 0147-5185

IS - 7

ER -