Endometrial Metaplastic/Reactive Changes Coexistent with Endometrial Hyperplasia and Carcinoma: A Morphological and Immunohistochemical Study

Travaglino, Antonio; Inzani, Frediano; Santoro, Angela; Arciuolo, Damiano; Piermattei, Alessia; Pasquini, Sandra; Scaglione, Giulia; D’Alessandris, Nicoletta; Valente, Michele; Raffone, Antonio; Fanfani, Francesco; Zannoni, Gian Franco

doi:10.3390/diagnostics12010063

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…For the assessment of DL, ResNet50 is regarded as a standard and accepted algorithm. In clinical practice, some changes in endometrial glands, such as the secretory phase, proliferative phase, endometrial hyperplasia without atypia, and atypical endometrial hyperplasia, were confused with EEC due to their morphologies overlapping 37 . An expert pathologist annotated the most typical area of the malignant area in H&E images to improve diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis subtype of endometrial carcinoma using a deep learning model based on histopathological images

Qi,

Li,

Guo

et al. 2023

Preprint

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The histological determination of endometrial carcinoma (EC) remains the keystone in the diagnostic process and helps patients receive appropriate and effective treatment. We focused on constructing a prognostic deep learning (DL) model, which was trained and validated using four independent cohorts of 4108 Hematoxylin and Eosin (H&E) stained images from 1027 patients with multiple magnifications. The model yields an averaged area under the receiver operating curve (AUROC) of 0.962 from the internal dataset, an AUROC of 0.878 on an external dataset from another medical center, and an AUROC of 0.930 on the different scanners dataset, and an AUROC of 0.926 on the poor quality slides dataset, respectively. The predictive value by DL was significant with the mutant P53 of EC (p<0.05). Furthermore, the predictive performance of the model was better than the primary and senior pathologist's prediction (AUC= 0.962, 0.722 and 0.868, respectively). The DL model can accurately highlight morphological characteristics in H&E images and provide indications into the diagnosis and stratification for the management.

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Section: Discussionmentioning

confidence: 99%

Diagnosis subtype of endometrial carcinoma using a deep learning model based on histopathological images

Qi,

Li,

Guo

et al. 2023

Preprint

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“…Federation of Gynecology and Obstetrics (FIGO) stage, serum cancer antigen 125 (CA-125) and human epididymis protein 4 (HE4), and histologic molecular markers have been investigated and analyzed in the diagnosis and prognosis of EC patients [7][8][9][10]. Meanwhile, 18F-fluorodeoxyglucose ( 18 F-FDG) PET/computed tomography (CT) combines morphological and physiologic imaging techniques and is widely used for diagnosis, staging and prognosis of various cancers.…”

Section: Many Clinicopathological Factors Including Internationalmentioning

confidence: 99%

“…Immunohistochemical staining of ER, PR, Ki-67, P53, and c-Met was performed and analyzed in EC specimens. ER and PR expressions were categorized as positive and negative expressions [10]. Ki-67 index was classified into high and low expression groups based on the median.…”

Section: Pathologymentioning

confidence: 99%

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Relationship between 18F-fluorodeoxyglucose PET/computed tomography metabolic parameters and clinicopathology in endometrial cancer

Yao

Tan

Zhang

et al. 2022

Nuclear Medicine Communications

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Objective Endometrial cancer (EC) is the most common invasive gynecological malignancy. This study aimed to retrospectively analyze the relationship between 18F-fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) parameters and clinicopathological factors in EC patients, and assess whether 18F-FDG PET/CT can be applied for predicting the expressed status of histologic molecular markers. Methods Pretreatment clinicopathological characteristics and 18F-FDG PET/CT parameters of maximum standard uptake value (SUVmax), metabolic tumor volume and total lesion glycolysis of primary lesion (MTV-P and TLG-P), and combination of primary lesion and metastases (MTV-C and TLG-C) were retrospectively reviewed in 101 patients with EC. Results The median age of these 101 patients was 55 years (range, 35–85 years), and 95 patients (94.1%) presented with abnormal vaginal bleeding, 26 patients (25.7%) with elevated serum cancer antigen 125 (CA-125) and 46 patients (45.5%) with increased human epididymis protein 4 (HE4). Sixty-nine cases were at International Federation of Gynecology and Obstetrics (FIGO) stage I, eight at stage II, 20 at stage III, and four at stage IV. FDG uptake was avid in all cases, and the median SUVmax, MTV-P, TLG-P, MTV-C, and TLG-C were 12.9 (range, 2.8–34.2), 8.1 (range, 0.9–547.8), 52.2 (range, 2.5–4420.6), 8.2 (range, 0.9–790.3), and 58.4 (range, 2.5–6972.2), respectively. Estrogen receptor (ER) and progesterone receptor (PR) positive expressions were in 93.1% (94/101) and 90.1% (91/101) patients, respectively. The median Ki-67 index of 101 cases was 40% (range, 0–95%). P53 pattern was tested in 89 patients and 24 cases were mutant type (27.0%). Mesenchymal-epithelial transition factor (c-Met) expression was investigated in 86 patients, and the positivity was in 36 patients (41.9%). Higher PET/CT metabolic parameters were observed in patients with elevated CA-125 and HE4, advanced FIGO stage and higher Ki-67 index (P < 0.05), but had no association with ER/PR expression, P53 pattern, and c-Met expression (P > 0.05). Conclusion FDG uptake in EC was associated with serum CA-125 and HE4, FIGO stage, and Ki-67 index, but no correlations were found between glucose metabolism and ER/PR, P53, and c-Met.

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“…It has been described in the endometrium, where it is considered a reactive change caused by tissue damage, such as inflammation and ischemia. Hobnail metaplasia is occasionally related to endometrial hyperplasia and papillary or pseudo-papillary changes(Stringfellow & Elliot, 2017;Travaglino et al, 2021). Given the known association between hobnail cells, papillary thickening of the epithelium and inflammation in different organ systems, further investigation into the possible role of inflammation in the pathogenesis of GOC or the expression of its features is warranted.The results of the present study may suggest that cysts with 5 or more microscopic characteristics and diffuse involvement of the cyst wall, as well as those with only 3-4 features and focal involvement represent a single spectrum of disease.…”

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confidence: 99%

Histopathological and histomorphometric analysis of glandular odontogenic cyst‐A diagnostic aid

et al. 2022

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ObjectivesCompare recognized microscopic parameters, including variations in width, plaque‐like thickenings, intra‐epithelial microcysts, clefts, mucous, hob‐nail, ciliated and clear cells, between glandular odontogenic cyst (GOC) and GOC‐like cysts, investigate the extent of cyst circumference exhibiting these features, and inflammation.Materials and MethodsArchival records of cysts with histological features of GOC evaluated between 2000 and2020 were retrieved. Slides were revised, and the expression of features throughout the cyst wall was analyzed. Cysts with at least 5 features were classified as GOC, cysts with 3–4 features as GOC‐like.ResultsThe study included 74 cysts, 47 males M, 25 females (2 unknown gender), aged 19–81 years, 62 (83.8%) GOC, 12 (16.2%) GOC‐like. Mandible was involved in 44 (59.5%), maxilla in 30 (40.5%), 18 (25%) were associated with unerupted teeth. Cyst classified as GOC had significantly higher rates of all parameters investigated, (except ciliated and clear cells), than GOC‐like cysts (p ≤ 0.05). 26 (40.6%) cases showed GOC features in >50% of cyst circumference, 21 (32.8%) involved 25–50%, 17 (26.6%) <25%. More than 50% circumference involvement was highly and independently predictive for a diagnosis of GOC, <25% was highly and independently predictive for GOC‐like (p = 0.003). Hobnail cells (p = 0.008) and plaque‐like thickenings (p = 0.038) were significantly more frequent in inflamed cysts.ConclusionBesides the number and type of histological features, GOC can be characterized by their distribution within the cyst circumference (focal Vs diffuse), and it may serve as a new diagnostic aid. It is suggested that GOC and GOC‐like may represent a single spectrum.

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Endometrial Metaplastic/Reactive Changes Coexistent with Endometrial Hyperplasia and Carcinoma: A Morphological and Immunohistochemical Study

Cited by 5 publications

References 23 publications

Diagnosis subtype of endometrial carcinoma using a deep learning model based on histopathological images

Diagnosis subtype of endometrial carcinoma using a deep learning model based on histopathological images

Relationship between 18F-fluorodeoxyglucose PET/computed tomography metabolic parameters and clinicopathology in endometrial cancer

Histopathological and histomorphometric analysis of glandular odontogenic cyst‐A diagnostic aid

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