[1175] Ease of Application of Diagnostic Criteria for Premalignant Endometrial Lesions

Jennifer Kaley, Aleksandra Melnyk, Josh Bornhorst, Chien Chen, Charles Quick. UAMS, Little Rock, AR

Background: Two classification systems are currently used to evaluate premalignant endometrial lesions: the World Health Organization (WHO) criteria and the endometrial intraepithelial neoplasia system (EIN). The WHO system is more widely used, but the EIN system has made recent gains in acceptance. The goal of this study was to determine the ease of use and reproducibility of the 2 systems among naive users.
Design: Twenty-two 3rd and 4th year medical school students, with no prior training in either system, reviewed an online, 20 minute, educational module on both systems' key histologic components and were assigned to take a quiz (48 questions) testing diagnostic criteria including: percent glands; percent stroma; gland to stroma ratio; presence of gland crowding; atypia; cytologic demarcation; and WHO or EIN diagnosis. The answers of both groups were compared with the consensus diagnosis of two gynecologic pathology trained pathologists.
Results: The results are listed in Table 1.

Gland Crowding (EIN)85% concordance
Gland : Stroma >1 (WHO)68% concordance
Cytologic Demarcation (EIN)68% concordance
Atypia (WHO)52% concordance
EIN Diagnosis85% concordance
WHO Diagnosis36% concordance
Percent GlandsMean standard deviation = 0.128
Percent StromaMean standard deviation = 0.107

Conclusions: These findings suggest that the application of EIN criteria is more reproducible than WHO criteria among naive users and that percent stroma is easier to evaluate than percent glands. Assuming both schemes provide similar prognostic predictive value, EIN is easier to learn and likely to provide more consistent results.
Category: Gynecologic & Obstetrics

Wednesday, March 6, 2013 1:00 PM

Poster Session VI # 200, Wednesday Afternoon


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