Singh Pushpa, Dwivedi Pooja, Mendiratta Shweta
PGIMER & Dr. R.M.L. Hospital, New Delhi, India.
CGHS Dispensory, New Delhi, India.
J Obstet Gynaecol India. 2016 Feb;66(1):42-6. doi: 10.1007/s13224-014-0627-z. Epub 2014 Nov 4.
Menopause is the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Bleeding that occurs 12 months after the last menstrual period is labeled as postmenopausal bleeding.
AIMS & OBJECTIVES: The aim of the present study was to study endometrial thickness by transvaginal sonography, and correlate it with the cytological pattern evaluated by endometrial aspiration and histopathological pattern of the hysteroscopic directed biopsy.
Sixty patients presenting with postmenopausal bleeding in outpatient department, after applying both inclusion and exclusion criteria, were enrolled in the present study. Majority (38.33 %) of patients had atrophic endometrium or normal endometrium. Endometrium was hyperplastic in 18 (30 %) patients, polyp in 6 (10 %) patients, and growth in 7 (11.67 %) patients. On histopathology, majority of patients (38.33 %) had atrophic endometrium. Endometrial hyperplasia was detected in 14 (23.33 %) out of which 11 had simple hyperplasia while 3 had atypical hyperplasia. Endometrial cancer was detected in 8 (13.33 %) patients. Out of 8 cases of endometrial malignancy, one case was confirmed as endometrial adenocarcinoma on histopathology.
Role of endometrial thickness cannot be undermined for detecting patients at high risk especially with comorbid conditions. Histo-pathological evaluation is mandatory for ruling out malignancy in selected cases of PMB through hysteroscopy.
绝经是由于卵巢卵泡活动丧失导致的月经永久性停止。最后一次月经后12个月出现的出血被标记为绝经后出血。
本研究的目的是通过经阴道超声检查子宫内膜厚度，并将其与通过子宫内膜抽吸评估的细胞学模式以及宫腔镜引导活检的组织病理学模式相关联。
在应用纳入和排除标准后，门诊60例出现绝经后出血的患者被纳入本研究。大多数（38.33%）患者的子宫内膜萎缩或正常。18例（30%）患者的子宫内膜增生，6例（10%）患者有息肉，7例（11.67%）患者有肿物。组织病理学检查显示，大多数患者（38.33%）的子宫内膜萎缩。14例（23.33%）检测到子宫内膜增生，其中11例为单纯性增生，3例为非典型增生。8例（13.33%）患者检测到子宫内膜癌。在8例子宫内膜恶性肿瘤病例中，1例经组织病理学确诊为子宫内膜腺癌。
子宫内膜厚度在检测高危患者尤其是合并症患者时的作用不可忽视。对于通过宫腔镜检查的部分绝经后出血病例，组织病理学评估对于排除恶性肿瘤是必不可少的。
