Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Arch Gynecol Obstet. 2011 Feb;283(2):261-6. doi: 10.1007/s00404-010-1601-3. Epub 2010 Aug 4.
Endometrial carcinoma is the most distressing cause of abnormal vaginal bleeding. The intention of clinical management in the case of postmenopausal bleeding is to achieve an accurate diagnosis without overinvestigation.
We studied the available literature on the diagnostic evaluation of postmenopausal women with vaginal bleeding, accentuating the most important aspects on this topic: the accuracy of sonography and endometrial biopsy in predicting endometrial hyperplasia and endometrial carcinoma.
The accuracy of the above tests in predicting endometrial hyperplasia and endometrial carcinoma is a subject of continuing debate. Μοreover, in the last decades, there has been an explosion of publications indicating that ultrasound may be useful in predicting endometrial pathology.
Since advanced endometrial carcinoma has been known to occur in cases without noticeable endometrial thickness on ultrasound, the clinician should beware of the diagnostic evaluation of postmenopausal women with vaginal bleeding.
子宫内膜癌是导致绝经后阴道出血的最令人痛苦的原因。对于绝经后出血的临床管理,目的是在不进行过度检查的情况下做出准确诊断。
我们研究了绝经后阴道出血妇女的诊断评估的现有文献,强调了该主题的最重要方面:超声和子宫内膜活检在预测子宫内膜增生和子宫内膜癌中的准确性。
上述检查在预测子宫内膜增生和子宫内膜癌中的准确性是一个持续争论的话题。此外,在过去几十年中,有大量出版物表明,超声可能有助于预测子宫内膜病变。
由于在超声检查中未见明显子宫内膜增厚的情况下也已发现晚期子宫内膜癌,因此临床医生应警惕对绝经后阴道出血妇女的诊断评估。