Endometrial Cancer: Study of the Precursors Lesions

Carcinoma of the endometrium is one of the most common gynecologic malignancies and its incidence is rising. It typically occurs in elderly patients; approximately 80% are postmenopausal at the time of diagnosis. It has been suggested that endometrial carcinoma can be divided in two distinct types on the basis of their pathogenesis: the more common one —occurring as a result of excess estrogenic stimulation and developing against a background of endometrial hyperplasia. In the present study the nuclear area and shape of epithelial cells were measured in cytological specimens from cases with precursors of endometrial cancer including 15 patients with cystic hyperplasia of the endometrium and 12 patients with adenomatous hyperplasia and compared with 10 patients having endometrial cancer. Only specimens from patients with histological confirmed widespread disease of the endometrium were accepted in the study. The mean nuclear area in cystic hyperplasia was significantly lower than in adenomatous hyperplasia. Results from measurements with the same method in normal and malignant conditions were compared with those from hyperplastic conditions. Cases with precursors of endometrial cancer both cystic and adenomatous hyperplasia differed from normal endometrium but not from malignant conditions. There were no differences in nuclear shape between cases with precursors of endometrial cancer, and cases with malignant conditions.