Curcić Aleksandar, Durdević Srdan, Mihaldzić-Tubić Slobodana, Mladenović-Segedi Ljiljana, Maksimović Marko
Klinicki centar Vojvodine, Novi Sad, Klinika za ginekologiju i akuserstvo.
Med Pregl. 2009 Jul-Aug;62(7-8):337-41. doi: 10.2298/mpns0908337c.
The aim, of this prospective study was to estimate whether the presence of endometrial fluid detected by transvaginal ultrasound investigation was a marker for the pathological changes of the endometrium in postmenopausal women.
128 postmenopausal women with uterine bleeding and 29 asymptomatic postmenopausal women underwent transvaginal ultrasound investigation, curettage and histopathological investigation of the curettage specimens.
There were significantly more asymptomatic women with endometrial fluid collection was found (41,4%) than those with uterine bleeding (7,8%) (p<0,001). We found 4 cases of carcinoma of the endometrium, 4 with hyperplasia and 1 with polyp of the endometrium in women with uterine bleeding and endometrial fluid collection. In the asymptomatic group of women we found 1 case with polyp and 1 with carcinoma of the endometrium. In the presence of endometrial fluid collection the least thickness of the endometrium measured by transvaginal ultrasound was 12 mm in postmenopausal women with carcinoma of the endometrium, 7 mm in women with hyperplasia and 5 mm with polyp. No pathological changes were found below the above values.
The presence of endometrial fluid detected by transvaginal ultrasonography is a good marker for pathological changes of the endometrium in postmenopausal women if the endometrial thickness is greater than 4 mm. If the endometrial thickness is 4 mm or less, the presence of endometrial fluid is not an indication for further invasive investigation of endometrial cavity, but we must eliminate possible presence of ednexal or cervical malignant disease in some patients.
本前瞻性研究的目的是评估经阴道超声检查发现的子宫内膜液的存在是否为绝经后女性子宫内膜病理变化的标志物。
128例有子宫出血的绝经后女性和29例无症状的绝经后女性接受了经阴道超声检查、刮宫及刮宫标本的组织病理学检查。
发现有子宫内膜积液的无症状女性(41.4%)明显多于有子宫出血的女性(7.8%)(p<0.001)。我们在有子宫出血和子宫内膜积液的女性中发现4例子宫内膜癌、4例增生和1例子宫内膜息肉。在无症状女性组中,我们发现1例息肉和1例子宫内膜癌。在有子宫内膜积液的情况下,经阴道超声测量的绝经后女性子宫内膜最薄厚度在子宫内膜癌患者中为12mm,增生患者中为7mm,息肉患者中为5mm。低于上述值未发现病理变化。
如果子宫内膜厚度大于4mm,经阴道超声检查发现的子宫内膜液的存在是绝经后女性子宫内膜病理变化的良好标志物。如果子宫内膜厚度为4mm或更小,子宫内膜液的存在不是进一步对子宫内膜腔进行侵入性检查的指征,但我们必须排除一些患者附件或宫颈恶性疾病的可能存在。