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The Korean Journal of Pathology 2008;42(2): 87-93.
A Multiinstitutional Consensus Study on the Pathologic Diagnosis of Endometrial Hyperplasia and Carcinoma.
Kwang Sun Suh, Insun Kim, Moon Hyang Park, Geung Hwan Ahn, Jin Hee Sohn, In Ae Park, Hye Kyoung Yoon, Kyu Rae Kim, Hee Jung An, Dong Won Kim, Mi Jin Kim, Hee Jae Joo, Eun Kyung Kim, Young Hee Choi, Chong Woo Yoo, Kyung Un Choi, Sang Yeop Yi, Hye Sun Kim, Sung Ran Hong, Hee Jeong Lee, Sun Lee
1Department of Pathology, Chungnam National University School of Medicine, Daejeon, Korea.
2Department of Pathology, Korea University, Seoul, Korea. skim@korea.ac.kr
3Department of Pathology, Hanyang University, Seoul, Korea.
4Department of Pathology, Sungkyunkwan University, Seoul, Korea.
5Department of Pathology, Seoul National University, Seoul, Korea.
6Department of Pathology, Inje University, Busan, Korea.
7Department of Pathology, Ulsan University, Seoul, Korea.
8Department of Pathology, Pochon CHA Hospital, Seongnam, Korea.
9Department of Pathology, Soonchunhyang University, Seoul, Korea.
10Department of Pathology, Youngnam University, Daegu, Korea.
11Department of Pathology, Aju University, Suwon, Korea.
12Department of Pathology, Eulji General Hospital, Seoul, Korea.
13Department of Pathology, Hallym University, Chuncheon, Korea.
14Department of Pathology, National Cancer Center, Goyang, Korea.
15Department of Pathology, Pusan National University, Busan, Korea.
16Department of Pathology, Kwandong University, Gangneung, Korea.
17Department of Pathology, Kangnam St. Mary's Hospital, Seoul, Korea.
18Department of Pathology, Kyunghee University Medical Center, Seoul, Korea.
19Department of Pathology, The Gynecologic Pathology Study Group of the Korean Society of Pathologists, Seoul, Korea.
ABSTRACT
BACKGROUND: The purpose of this study was to examine the reproducibility of both the diagnosis of endometrial hyperplasia (EH) or adenocarcinoma, and the histologic grading (HG) of endometrioid adenocarcinoma (EC). METHODS: Ninety-three cases of EH or adenocarcinomas were reviewed independently by 21 pathologists of the Gynecologic Pathology Study Group. A consensus diagnosis was defined as agreement among more than two thirds of the 21 pathologists. RESULTS: There was no agreement on the diagnosis in 13 cases (14.0%). According to the consensus review, six of the 11 EH cases (54.5%) were diagnosed as EH, 48 of the 57 EC cases (84.2%) were EC, and 5 of the 6 serous carcinomas (SC) (83.3%) were SC. There was no consensus for the 6 atypical EH (AEH) cases. On the HG of EC, there was no agreement in 2 cases (3.5%). According to the consensus review, 30 of the 33 G1 cases (90.9%) were G1, 11 of the 18 G2 cases (61.1%) were G2, and 4 of the 4 G3 cases (100.0%) were G3. CONCLUSIONS: The consensus study showed high agreement for both EC and SC, but there was no consensus for AEH. The reproducibility for the HG of G2 was poor. We suggest that simplification of the classification of EH and a two-tiered grading system for EC will be necessary.
Key Words: Endometrioid adenocarcinoma; Serous carcinoma; Endometrial hyperplasia