Abdullah Abdulrazak Aiad
Department of Pathology, Tikrit college of Medicine, University of Tikrit, Iraq.
Acta Inform Med. 2012 Jun;20(2):94-8. doi: 10.5455/aim.2012.20.94-98.
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".
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.
The volume of stroma (VPS) was significantly higher in proliferative than secretory and hyperplastic endometria. The glandular surface density were higher in secretory endometria than proliferative and hyperplastic 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 & significantly higher mean values of contour index than proliferative and secretory endometria. 67% of hyperplastic endometria show D-score values < 0.
It seems feasible to estimate D-score using a semi-automated workstation based on the simple stereologic and morphometric principles.
癌前子宫内膜病变的诊断对病理学家来说是一项重大挑战。D评分系统比世界卫生组织的方案更具可重复性，然而它并未广泛应用，本研究证明了一种用于估算“D评分”的简单定制工作站。
对15例低度增生性子宫内膜、15例增殖期子宫内膜和8例分泌期子宫内膜进行光学显微镜检查和体视学分析。我们测定了腺体和间质的体积及表面密度。估算了子宫内膜腺上皮细胞的核测量参数。根据一些结构和核测量参数计算D评分。
增殖期子宫内膜的间质体积（VPS）显著高于分泌期和增生期子宫内膜。分泌期子宫内膜的腺表面密度高于增殖期和增生期子宫内膜，然而，差异无统计学意义。分泌期子宫内膜最长核轴与最短核轴的比值显著低于增殖期和增生期子宫内膜。分泌期子宫内膜的形状因子平均值也显著低于增殖期和增生期子宫内膜，轮廓指数平均值则显著高于增殖期和增生期子宫内膜。67%的增生期子宫内膜D评分值<0。
基于简单的体视学和形态测量学原理，使用半自动工作站估算D评分似乎是可行的。
