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P68 Diagnostic accuracy of endometrial biopsy in endometrial carcinoma grading, correlated to the amount of tissue
  1. AMC Hulsman1,
  2. C Reijnen1,
  3. J Bulten1,
  4. HVN Kusters2,
  5. K van de Vijver3,
  6. M Santacana4,
  7. E Colas5,
  8. G Mancebo6,
  9. A Reques7,
  10. A Gil-Moreno5,7,
  11. J Trovik8,
  12. C Krakstad8,9,
  13. J Huvila10,
  14. IS Haldorsen8,9,
  15. HR Engerud8,9,
  16. M Koskas11,
  17. V Weinberger12,
  18. L Minar12,
  19. E Jandakova12,
  20. X Matias-Guiu4,
  21. F Armant13,14,
  22. LFAG Massuger1,
  23. MPLM Snijders2 and
  24. JMA Pijnenborg1
  1. 1Radboud University Medical Centre
  2. 2Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
  3. 3Ghent University Hospital, Cancer Research Institute Ghent (CRIG), Ghent, Belgium
  4. 4Hospital Universitari Arnau de Vilanova, Lleida
  5. 5Vall Hebron Institute of Research
  6. 6Hospital del Mar
  7. 7Vall Hebron University Hospital, Barcelona, Spain
  8. 8Haukeland University Hospital
  9. 9University of Bergen, Bergen, Norway
  10. 10University of Turku, Turku, Finland
  11. 11Bichat-Claude Bernard Hospital, Paris, France
  12. 12Masaryk University, Brno, Czech Republic
  13. 13KU Leuven, Leuven, Belgium
  14. 14Centre for Gynaecological Oncology Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands


Introduction/Background The diagnostic accuracy of endometrial biopsy has been related to the amount of tissue. In endometrial cancer (EC) there is only moderate agreement on tumor grade between preoperative endometrial sampling and final diagnosis with the lowest agreement for grade 2 carcinoma. Since the amount of preoperative endometrial tumor tissue has not yet been related to the degree of discordance, we aim to determine this relation with regard to final tumor type and grade.

Methodology Within the European Network for Individualized Treatment of Endometrial Cancer (ENITEC), 582 preoperative endometrial biopsy samples of EC patients were retrospectively collected and classified into low-grade (grade 1–2) and high-grade carcinoma (grade 3). The endometrial tissue surface was digitally calculated using ImageJ software and the correlation between the amount of tissue and concordance of diagnosis was calculated.

Results Agreement on tumor grade between preoperative endometrial sampling and final diagnosis was 62.5%. Up- or downgrading was found in respectively 27.1% and 10.3%. Clinically relevant up- or downgrading was found in respectively 7.8% and 27% of the cases. Premalignant endometrial tissue contained less endometrium compared to malignant endometrium (4.4 vs. 19.3 mm2,p=0.03). Serous EC contained less endometrial tissue compared with grade 1–3 endometrioid EC (13.0 vs. 19.1 mm2,p=0.017). The median endometrial tissue surfaces of grade 1-3 did not significantly differ from each other (18.7 vs. 19.8 vs. 24.1 mm2). Samples with a discordant diagnosis consisted of significantly more endometrial tissue compared to the concordant group (p=0.018).

Conclusion Based on postoperative diagnosis, there is no difference in the amount of endometrial tissue between the different endometrial grades. However, there is a tendency to underestimate a sample with less and overestimate a sample with more endometrial tissue. Awareness is especially needed, in serous EC with in general less tissue.

Disclosure Nothing to disclose.

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