Alcázar Juan Luis, Bonilla Laura, Marucco Julia, Padilla Ana Isabel, Chacón Enrique, Manzour Nabil, Salas Aina
Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.
Department of Obstetrics and Gynecology, University Hospital Virgen de las Nieves, Granada, Spain.
J Clin Ultrasound. 2018 Nov;46(9):565-570. doi: 10.1002/jcu.22631. Epub 2018 Aug 16.
To evaluate the risk of endometrial cancer and/or endometrial hyperplasia with atypia in asymptomatic postmenopausal women with endometrial thickness ≥ 11 mm.
Systematic review of literature using database search (PubMed and Web of Science) of articles published between January 1990 and December 2016 evaluating the correlation between endometrial thickness as measured by transvaginal ultrasound (double layer) and histopathological findings in asymptomatic postmenopausal women, using the following terms: "endometrial thickness," "postmenopausal," "postmenopause," and "asymptomatic." Inclusion criteria were prospective or retrospective studies of more than 150 cases that provided information on endometrial thickness and its correlation with histopathological data. Studies that included patients with hormone replacement therapy, tamoxifen, or aromatase inhibitors were excluded. The overall relative risk (RR) for EC/EHA was calculated, stratifying the patients into two groups according to endometrial thickness (<11 mm and ≥11 mm). Heterogeneity was assessed by calculating I .
The search identified 289 studies. After exclusions, nine articles that met all the inclusion criteria were included, comprising data from 4751 women. The prevalence of endometrial cancer and/or endometrial hyperplasia with atypia was 2.4%. The relative risk of endometrial cancer and/or endometrial hyperplasia with atypia in the ≥11 mm group was 2.59 (95% CI: 1.66-4.05). High heterogeneity was observed between studies (I : 57.3%, P = .016).
Overall the risk for EC/EHA was 2.6 times greater in women with ET ≥11 mm vs women with ET 5-10 mm, although there was significant heterogeneity in estimates across studies.
评估子宫内膜厚度≥11mm的无症状绝经后女性患子宫内膜癌和/或不典型子宫内膜增生的风险。
通过数据库检索（PubMed和Web of Science）对1990年1月至2016年12月发表的文章进行系统文献回顾，这些文章评估了经阴道超声测量的（双层）子宫内膜厚度与无症状绝经后女性组织病理学结果之间的相关性，检索词如下：“子宫内膜厚度”、“绝经后”、“绝经后期”和“无症状”。纳入标准为超过150例的前瞻性或回顾性研究，这些研究提供了子宫内膜厚度及其与组织病理学数据相关性的信息。排除纳入了接受激素替代治疗、他莫昔芬或芳香化酶抑制剂治疗患者的研究。计算子宫内膜癌/不典型子宫内膜增生的总体相对风险（RR），根据子宫内膜厚度（<11mm和≥11mm）将患者分为两组。通过计算I评估异质性。
检索到289项研究。排除后，纳入了9篇符合所有纳入标准的文章，包含来自4751名女性的数据。子宫内膜癌和/或不典型子宫内膜增生的患病率为2.4%。≥11mm组中子宫内膜癌和/或不典型子宫内膜增生的相对风险为2.59（95%CI：1.66 - 4.05）。研究间观察到高度异质性（I：57.3%，P = 0.016）。
总体而言，子宫内膜厚度≥11mm的女性患子宫内膜癌/不典型子宫内膜增生的风险是子宫内膜厚度为5 - 10mm女性的2.6倍，尽管各研究的估计值存在显著异质性。
