REPRODUCIBILITY OF THE DIAGNOSES OF ENDOMETRIAL HYPERPLASIA ACCORDING TO THE WHO CLASSIFICATION AND THE MODIFIED (BINARY) CLASSIFICATION

Objective. to study of the reproducibility of the diagnoses of endometrial hyperplasia (EH) by the leading gynecological pathologists of Moscow on the basis of the WHO classification (2003) and the modified (binary) classification that proposes two types of EH instead of four ones. Materials and methods. The study included 60 histological endometrial scraping specimens with diagnosed different types of EH, low-grade adenocarcinoma of the endometrium and the corpus uteri mucosa at the stage of proliferation and secretion. Results. There was a coincidence of the WHO classification-based diagnoses among the pathologists when examining endometrial scrapes in 31 of the 60 women; the other cases showed a discrepancy in the diagnoses. The к index in the diagnosis of the intact and abnormally altered endometrium averaged 0.59 (0.91 to 0.61). With the binary system for the diagnoses of endometrial pathological changes being used, there was a coincidence in histological conclusions made by the pathologists in 48 (80%) cases. The к index in the diagnosis of low- and high-grade EH averaged 0.72 (0.68 to 0.74). Conclusion. When the binary system is applied, the reproducibility rate for the diagnoses of EH is higher than that when the WHO classification is used, which permits the authors to recommend the binary classification to improve the diagnosis of EH. The reproducibility of its diagnoses can be also enhanced using immunohistochemical markers, among which the tumor suppressor PTEN, the proliferative marker Ki-67, the apoptotic marker Bcl-2, as well as steroid hormone receptors, insulin-like growth factors, and their receptors are most important.

endometrial hyperplasia, reproducibility of the diagnoses of endometrial hyperplasia, classification of female genital tumors, tumor suppressor PTEN