Concordance of FIGO grade of endometrial adenocarcinomas in biopsy and hysterectomy specimens

Histopathology. 2003 Apr;42(4):372-8. doi: 10.1046/j.1365-2559.2003.01603.x.


Aims: We compared the FIGO grade of endometrial adenocarcinomas in endometrial samples and subsequent hysterectomy specimens, between 1997 and 2000 in a general pathology department. Our aims were to assess concordance, and the influence of the sampling technique, patient age, reporting pathologist and interval between the biopsy and definitive surgery. In order that the study reflected working practice, the tumour grade given by the reporting pathologist was used whenever possible.

Methods and results: Endometrial samples and the subsequent hysterectomy specimens from 125 patients were studied. The comparative FIGO grades were analysed with reference to biopsy type, patient age, reporting pathologist and interval between biopsy and hysterectomy. Concordance was 45% for grade 1, 63.3% for grade 2 and 75.6% for grade 3 carcinomas, the overall concordance being 64.5%. The concordance for grade 3 tumours was significantly higher than for grade 1. The predictive accuracy was independent of biopsy type, patient age, the interval between biopsy and hysterectomy, and whether the same pathologist reported both specimens.

Conclusions: Irrespective of the sampling device used, patient age, time-lapse between biopsy and hysterectomy, or whether the same pathologist reported both specimens, the grade of endometrial adenocarcinoma often differs in the initial biopsy sample from that in the final hysterectomy specimen. This may have important implications for patient management, especially for tumours that yield low-grade biopsies.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / classification
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy / methods*
  • Cell Nucleus / classification
  • Cell Nucleus / pathology
  • Dilatation and Curettage
  • Endometrial Neoplasms / classification
  • Endometrial Neoplasms / pathology*
  • Endometrial Neoplasms / surgery
  • Female
  • Humans
  • Hysterectomy*
  • Middle Aged
  • Reproducibility of Results
  • Time Factors