[Correlations between the ultrasound aspects of endometrial hyperplasias and the pathological exam]

The endometrium has a few possibilities to express the underlying pathology, even if there may be a potential dangerous one. This study is searching for a relationship between the ultrasound images of endometrial hyperplasias and the respective pathologic exams.

MATERIAL AND METHOD

We analyzed 385 cases of endometrial hyperplasias hospitalized in the "Elena Doamna" Maternity from Iaşi, Romania during the period 2000-2005.

RESULTS

For all the cases included, the endometrium had a width from 2 mm to 20 mm, with a median of 9mm. The hyperplasias were: 70.18% simple hyperplasias without atypia, 18.52% complex hyperplasias without atypia, 7.1% complex hyperplasias with atypia and 4.17% secretory hyperplasias. There were no differences between the aspects or thickness of the endometrium in regard with any of the types of hyperplasias.

CONCLUSIONS

Ultrasounds exams have a limited role to diagnose endometrial hyperplasias. They only selects patients for mandatory other investigations. Key words:

[The evaluation of different methods of paraclinical diagnosis in endometrial hyperplasia and endometrial cancer of women in perimenopause]

Almost all types of endometrial pathology in perimenopause have the same clinical features. That's why the paraclinical methods are the most useful for diagnosis.

OBJECTIVE

To find which of the following: Pap smear, sonography, hysterography or hysteroscopy is more appropriate for the diagnosis.

MATERIAL AND METHOD

We investigated 218 cases of endometrial hyperplasias and 57 of endometrial cancer between 45-74 years old. The final diagnosis was settled by pathological exam.

RESULTS

For both of them the Pap smears has no significance; hysterography is not specific and old fashioned; the sonography may diagnose the disease but the hysteroscopy put the diagnosis in 87% cases of endometrial hyperplasias. In endometrial cancer the sonography separate the normal cases from the suspects and the hysteroscopy put the diagnosis in all cases but can not appreciate the myometrial invasion.

CONCLUSION

There is no paraclinical method to be used alone for a correct diagnosis. Sonography can choose, hysteroscopy and biopsy put the diagnosis and treat.

[Endometrial hyperplasias immunohistochemical aspects]

Endometrial hyperplasias are now diagnosed according to the histopathological examination. By using immunohistochemistry, the authors search for supplementary elements for the diagnosis and evaluation of the prognosis of this nosologic framework.

MATERIAL AND METHODS

We investigated a number of 138 cases of endometrial hyperplasia, using immunohistochemical research. The avidine-biotin-peroxidase method revealed estrogenic and progesterone receptors, together with EGF, proliferative Ki67 and cyclin D1.

RESULTS

The reaction was positive in variable percents for estrogenic receptors, especially for complex atypical hyperplasias. A positive immunoreactivity was also found for progesterone receptors and for Ki67 (in atypical hyperplasias); cyclin D1 revealed only a moderate reaction.

CONCLUSIONS

Immunohistochemistry can be useful for the prognosis of the lesion, but it is not indispensable for diagnosis, while the histopathologic examination is absolutely necessary for a complete endometrial hyperplasia diagnosis.