Endometrial thickness cut-off value by transvaginal ultrasonography for screening of endometrial pathology in premenopausal and postmenopausal women
Obstetrics & Gynecology Science
; : 445-453, 2019.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-760674
Responsible library:
WPRO
ABSTRACT
OBJECTIVE:
To assess the clinical usefulness and diagnostic accuracy of ultrasonographic measurement of endometrial thickness (ET) in women with endometrial hyperplasia or cancer (EH+).METHODS:
This retrospective cohort study included 29,995 consecutive women who underwent transvaginal ultrasonography (TVS) for an incidental finding of a thickened endometrium at the health screening and promotion center at Asan Medical Center between 2006 and 2010. Among 959 patients with endometrial abnormalities, 92 patients were included in this study. A total of 867 patients were excluded 416 were lost to follow-up; 263 did not undergo endometrial biopsy; 155 had endometrial polyps; 17 had submucosal myomas; and 16 had insufficient tissue samples. Endometrial histology was the reference standard for calculating accuracy.RESULTS:
Of the 92 patients, 78 (84.8%) had normal pathology, while 14 (15.2%) had endometrial pathology (EH+), including 5 patients (35.7%) with simple hyperplasia without atypia, 3 (21.4%) with complex hyperplasia, and 6 (42.9%) with endometrial carcinoma, all stage Ia. The area under the receiver-operating characteristic curve was 0.75 (95% confidence interval [CI], 0.593–0.906). The cut-off value for ET was 8 mm, indicating that TVS ET had a fair accuracy in diagnosing carcinoma, had a sensitivity of 100% (95% CI, 62.9–100.0%) and a specificity of 24.3% (95% CI, 15.2–36.3%).CONCLUSION:
TVS is useful for detecting EH+, with a cut-off value for ET of 8 mm having a high sensitivity for detecting endometrial pathologies and the ability to identify women highly unlikely to have EH+, thereby avoiding more invasive endometrial biopsy.
Full text:
Available
Health context:
SDG3 - Health and Well-Being
Health problem:
Target 3.4: Reduce premature mortality due to noncommunicable diseases
Database:
WPRIM (Western Pacific)
Main subject:
Pathology
/
Polyps
/
Biopsy
/
Mass Screening
/
Retrospective Studies
/
Cohort Studies
/
Ultrasonography
/
Sensitivity and Specificity
/
Endometrial Neoplasms
/
Incidental Findings
Type of study:
Diagnostic study
/
Etiology study
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Incidence study
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Observational study
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Prognostic study
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Risk factors
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Screening study
Limits:
Female
/
Humans
Language:
English
Journal:
Obstetrics & Gynecology Science
Year:
2019
Document type:
Article