Ulu I, Celik A, Haliloğlu B, Ilter E, Midi A
Eur J Gynaecol Oncol. 2016 Aug;37(4):474-477.
The purpose of the study was to assess the reliability of transvaginal ultrasound (TVUSG) in endometrial pathologies by comparing the ultrasonographic and histopathologic findings in symptomatic and asymptomatic postmenopausal women.
In this retrospective study the data of 129 postmenopausal women that underwent dilatation and curettage was reviewed by dividing them two groups as symptomatic and asymptomatic. Symptomatic group was divided into subgroups according to the value of endometrial thickness obtained by TVUSG.
Among all subjects the cancer rate was found statistically 3.043 times higher in patients with the endometrial thickness of 15 mm and greater and atrophic endometrium rate was 75% in patients with the endometrial thickness of less than five mm. Endometrial thickness was found significantly higher in cancer patients than the others (p < 0.05). Among the patients with endometrial thickness of 15 mm and greater, the cancer rate was found higher in symptomatic group than in the asymptomatic group. The cancer rate was found statistically higher in patients with bleeding compared to asymptomatic ones with the endometrial thickness between 5-14.99 mm (p < 0.05). Cancer was not detected in any of the symptomatic patients with the endometrial thickness of less than five mm.
Postmenopausal patients with the symptom of bleeding should undergo detailed gynecological and ultrasonographic examination. The authors believe that this study may be a strong support to the success of TVUSG as a screening method in both symptomatic and asymptomatic postmenopausal women. Furthermore if the patient is symptomatic with a thick endometrium, to exclude the malignancy, endometrial biopsy must be performed.
本研究的目的是通过比较有症状和无症状绝经后妇女的超声检查结果和组织病理学结果,评估经阴道超声(TVUSG)在子宫内膜病变诊断中的可靠性。
在这项回顾性研究中,对129例行刮宫术的绝经后妇女的数据进行了回顾,将她们分为有症状组和无症状组。有症状组根据经阴道超声获得的子宫内膜厚度值进一步分为亚组。
在所有受试者中,子宫内膜厚度≥15mm的患者癌症发生率在统计学上比其他患者高3.043倍,子宫内膜厚度<5mm的患者萎缩性子宫内膜发生率为75%。癌症患者的子宫内膜厚度显著高于其他患者(p<0.05)。在子宫内膜厚度≥15mm的患者中,有症状组的癌症发生率高于无症状组。在子宫内膜厚度为5-14.99mm的患者中,有出血症状的患者癌症发生率在统计学上高于无症状患者(p<0.05)。在子宫内膜厚度<5mm的有症状患者中未检测到癌症。
有出血症状的绝经后患者应接受详细的妇科和超声检查。作者认为,本研究可能有力支持经阴道超声作为有症状和无症状绝经后妇女筛查方法的成功应用。此外,如果患者有症状且子宫内膜增厚,为排除恶性肿瘤,必须进行子宫内膜活检。