A Study of histopathological spectrum of endometrial lesions in abnormal uterine bleeding with analysis of expression pattern of ER, PR and Ki-67.

Themthingla Zimik; Deepa Longjam; Sushila Devi L

Volume : IX, Issue : VI, June - 2020

A Study of histopathological spectrum of endometrial lesions in abnormal uterine bleeding with analysis of expression pattern of ER, PR and Ki-67.

Themthingla Zimik, Deepa Longjam, Sushila Devi L

Abstract :

Introduction Abnornal uterine bleeding (AUB) is defined as bleeding that does not correspond to the normal pattern of menstrual cycle. It is one of the most frequently encountered gynaecological problem.A spectrum of histologic changes are noted in the endometrium in AUB which vary according to the age of the patient and includes functional pattern or organic lesions.Histopathologic study of endometrial tissue is a major diagnostic tool in patients presenting with AUB. Aim To study the various morphologic pattern of endometrial lesions in patients with abnormal uterine bleeding and to analyse the Estrogen receptor(ER), Progersterone receptor(PR) and Ki–67 expression in samples showing hyperplasia and carcinoma. Method This is a prospective study of 70 endometrial specimens from patients diagnosed clinically as having AUB. The study was done in the department of Pathology JNIMS from January 2017 to June 2019.The samples underwent routine processing and were stained with Hematoxylin and eosin. Immunohistochemistry for ER,PR,KI–67 were done on samples showing hyperplasia or carcinoma. Result Out of the 70 cases studied, maximum number of cases were seen in the age group of 41–50 years. Age of the patients ranged from 18 to 72 years. In premenopausal women the most common histopathologic pattern was proliferative endometrium (32.7%). In post menopausal women atrophic endometrium was the most frequent pattern(27.7%).Endometrial hyperplasia was noted in 12 cases (17.1%) and there were 3 cases(4.3%) of endometrial carcinoma.ER and PR were positive in all cases of endometrial hyperplasia and 2 cases of endometrial carcinoma. High Ki–67 expression was noted in all the 3 cases of endometrial carcinoma. Conclusion Histopathologic evaluation of endometrial samples is necessary for deciding the appropriate therapeutic strategy. A wide spectrum of lesions from proliferative endometrium to carcinomas were noted in these patients.