Determining a threshold measurement of endometrial thickness for asymptomatic postmenopausal women: A tertiary centre case series.
Aust N Z J Obstet Gynaecol
; 62(6): 887-893, 2022 12.
Article
in En
| MEDLINE
| ID: mdl-35989428
ABSTRACT
BACKGROUND:
An incidental finding of a thickened endometrium on ultrasound in the postmenopausal patient without bleeding is a common presentation to gynaecological services; however there is limited evidence to guide clinical practice as to when hysteroscopic evaluation and endometrial sampling is required.AIMS:
To determine the endometrial thickness at which endometrial sampling is indicated in asymptomatic postmenopausal women referred with thickened endometrium on ultrasound. MATERIALS ANDMETHODS:
A single-centre retrospective case series of postmenopausal women without bleeding undergoing hysteroscopy was conducted. Logistic regression was used to examine the association between a range of variables and pre-malignant or malignant pathology and endometrial thickness. The optimal endometrial thickness threshold was identified to maximise model sensitivity.RESULTS:
A total of 404 postmenopausal women were included in this study, having undergone a hysteroscopy at the study site between 1 July 2008 and 30 June 2018. The mean (SD) age of patients at presentation was 65 (9.09) years and the mean body mass index was 29.86 kg/m2 (6.52). Of these women, nine (2.2%) were diagnosed with endometrial carcinoma and seven (1.7%) had endometrial hyperplasia with atypia. The most common histopathological finding was of a benign endometrial polyp (153 37.9%). When including hyperplasia with or without atypia in histopathology of interest, a cut-off of ≥9 mm provides the greatest sensitivity (83.3%) and specificity (63.8%) for a diagnosis of pre-malignant or malignant pathology (classification accuracy of 64.8%; area under the receiver operating characteristic 0.7358, 95% CI 0.6439, 0.8278) in this cohort.CONCLUSIONS:
Using an endometrial thickness of ≥9 mm can be used as a cut-off for endometrial sampling in postmenopausal women without bleeding.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Polyps
/
Endometrial Neoplasms
/
Endometrial Hyperplasia
Type of study:
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
/
Pregnancy
Language:
En
Year:
2022
Type:
Article