Progression curves for endometrial lesions

OBJECTIVE: To derive a numeric measure for the progression of endometrial l esions as a baseline study for an eventual assessment of chemopreventive in tervention efficacy. STUDY DESIGN: Tissue sections from normal endometrium at the proliferative and secretory phase, simple hyperplasia, atypical hyperplasia from cases fr ee of concomitant adenocarcinoma and adenocarcinoma of the endometrium were recorded at high spatial resolution. Six cases from each diagnostic catego ry were chosen as "typical," and 60 epithelial nuclei were randomly selecte d for measurement for each case. Discriminant analyses were carried out to derive a direction of progressive change in feature space and to correct th e progression curve for the presence of cells nor expressing progressive ch ange among the random sample of nuclei. RESULTS: A well-conditioned progression curve was derived based on the mean discriminant function scores for each diagnostic category and the mean nuc lear abnormality of the nuclei in each category, as expressed by their devi ation in feature values from normal reference nuclei. The lesion signatures showed a clear trend toward extension into the range of higher nuclear abn ormalities with increasing progression. There was an indication that abnorm al endometrial lesions may comprise cases with distinctly different degrees of nuclear abnormality. CONCLUSION: A numeric assessment of lesion progression for endometrial lesi ons, based on karyometric measurements, is possible. The data suggest that additional analysis may provide further characterizing information for indi vidual lesions.