Value of vaginal ultrasound in finding the endometrial cancer in the postmenopausal women with bleedin

ABSTRACT

Diagnostic curettage has for many years been the method of choice to diagnose endometrial cancer in women with postmenopausal bleeding. In fact, approximately only 10% in this group of women will be diagnosed with endometrial cancer. This study used endometrial thickness as measured by endovaginal ultrasonography as an indicator of endometrial abnormality. The histopathologic diagnosis obtained at curettage is used as the gold standard. 74 women were included in this study. Endometrial cancer was not found with the endometrium= 5 mm thick. The mean endometrial thickness in those women with endometrial cancer was 13.72+/- 8.09 mm compared with 4.3 +/- 2.3 mm in those women with benign endometrium. If the cut off limit for endometrial cancer and hyperplasia was 5 mm, the sensitivity was 100% the specificity was 71.2%, the positive predictive value was 60%, the negative predictive value was 100% and the Kappa ratio was 0.6%. If this limit had been used in this study, 70% of the curettage procedures could have been avoided.