Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias

J P Baak, A Ørbo, P J van Diest, M Jiwa, P de Bruin, M Broeckaert, W Snijders, P J Boodt, G Fons, C Burger, R H Verheijen, P W Houben, H S The, P Kenemans

Research output: Contribution to journalArticleAcademicpeer-review


Prospective multicenter evaluation of the WHO classification and the morphometric D-score to predict endometrial hyperplasia cancer progression. In 132 endometrial hyperplasias WHO classification was performed by two experienced gynecologic pathologists. The D-score was assessed blindly by technicians in a routine diagnostic setting. Development of endometrial carcinoma during a 1-10-year follow-up was used as the end point. Eleven of 132 patients (8%), 10 of 61 (16%) atypical hyperplasias, and 1 of 71 (1%) nonatypical hyperplasias developed cancer. Twenty-six curettings had a D-score < or = 0 ("unfavorable" or endometrial intraepithelial neoplasia) of which 10 (38%) developed cancer. None of the 86 cases with a D-score > 1 ("favorable") and one of the 20 (5%) cases with 0 < D-score < or = 1 ("uncertain") developed cancer. Sensitivity of the D-score was 100%, specificity 82%, the positive and negative predictive values were 38% and 100%, respectively. These values are similar to those in three prior retrospective D-score studies but higher than the WHO values (which are 91%, 58%, 16%, and 99%, respectively). The D-score in endometrial hyperplasias is a more sensitive and specific marker for cancer prediction than the WHO classification, can be assessed in a routine clinical setting on standard hematoxylin and eosin sections (15-30 minutes per case), and is highly reproducible and cost-effective (U.S. $50 per case).

Original languageEnglish
Pages (from-to)930-5
Number of pages6
JournalAmerican Journal of Surgical Pathology
Issue number7
Publication statusPublished - Jul 2001


  • Adult
  • Aged
  • Aged, 80 and over
  • Discriminant Analysis
  • Disease Progression
  • Endometrial Hyperplasia
  • Endometrial Neoplasms
  • Female
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Pathology
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Sensitivity and Specificity
  • Single-Blind Method
  • World Health Organization


Dive into the research topics of 'Prospective multicenter evaluation of the morphometric D-score for prediction of the outcome of endometrial hyperplasias'. Together they form a unique fingerprint.

Cite this