Morphometric analysis of endometrial adenocarcinoma: 2. A comparison of architectural differentiation determined morphometrically with subjective grading

Architectural differentiation is the primary criterion used in the grading of endometrial adenocarcinomas. However, there is little evidence supporting the accuracy of pathologists’ assignment of histologic grade, and few studies on the value of architectural morphometry in predicting prognosis for endometrial adenocarcinoma. We have thus investigated whether a pathol-ogist’s estimate of percentage of tumor in solid array correlated with the volume fraction of tumors composed of cells not participating in gland formation determined morphometrically. Additionally, we conducted this morphometric study of 31 cases of Stage I endometrial cancer to determine the relationship between a variety of objective measurements of architectural arrangement and prognosis. We found that a pathologist can accurately estimate the proportion of endometrial tumors arranged in solid or glandular fashion. In this limited study, morphometric assessment of the proportion of differentiated or undifferentiated cells or lumens did not improve the accuracy of prediction of outcome beyond conventional architectural grading. Further, we reaffirm that estimation of architectural arrangement coupled with measurement of the depth of penetration provides a good index of the probability of survival.