Department of Gynecology and Obstetrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Department of Ultrasound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Ann Palliat Med. 2021 Oct;10(10):10840-10848. doi: 10.21037/apm-21-2516.
Endometrial thickness (ET) is closely related to many gynecological symptoms. The measurement of ET is also an important tool for evaluating adverse symptoms such as bleeding in postmenopausal women. However, the significance of ET in asymptomatic women is still unclear. The purpose of this study was to determine the correlation between ET and the incidence of endometrial lesions in asymptomatic women after menopause, and to statistically analyze the correlation with a 5 mm cutoff value.
A systematic literature search was conducted in May 2021 to screen out articles that reported that ET measurement was used to diagnose endometrial carcinoma (EC), endometrial hyperplasia (EH), and endometrial polyps (EP) in asymptomatic postmenopausal women who did not use hormone replacement therapy (HRT). The endometrial membrane was set at 5 mm as the cut-off, and using 5 mm as the cut-off of the ET, the relationship between the thickness of the endometrium and the prevalence of EC, EH, and EP was evaluated. Relative risk (RR) and standardized mean difference (SMD) were extrapolated with 95% confidence interval (CI).
After screening, 9 studies reported a total of 3,620 cases of asymptomatic postmenopausal women whose ET was measured. Among them, there were 1,758 cases of ET <5 mm, the probability of EC, EH, and EP were 0.284% (5/1,758), 0.398% (7/1,758), and 0.626% (11/1,758), respectively. In another 1,862 cases with ET ≥5 mm, the probabilities of EC, EH, and EP were 1.128% (21/1,862), 1.128% (21/1,862), and 1.557% (29/1,862), respectively. The results showed that ET can be used as a risk factor for predicting EC and other pathological changes.
The results of this meta-analysis show that when the ET is greater than 5 mm, the incidence of EC, EH, and EP increases significantly. It is reasonable to use ET as a screening test for EC and EH in asymptomatic postmenopausal women.
子宫内膜厚度（ET）与许多妇科症状密切相关。ET 的测量也是评估绝经后妇女出血等不良症状的重要工具。然而，ET 在无症状妇女中的意义尚不清楚。本研究旨在确定 ET 与绝经后无症状妇女子宫内膜病变发生率的相关性，并使用 5mm 作为截断值进行统计学分析。
2021 年 5 月进行系统文献检索，筛选出报告使用 ET 测量诊断无症状绝经后未接受激素替代治疗（HRT）的妇女子宫内膜癌（EC）、子宫内膜增生（EH）和子宫内膜息肉（EP）的文章。将子宫内膜膜设置为 5mm 作为截断值，使用 5mm 作为 ET 的截断值，评估子宫内膜厚度与 EC、EH 和 EP 患病率之间的关系。用 95%置信区间（CI）推断相对风险（RR）和标准化均数差（SMD）。
筛选后，9 项研究共报告了 3620 例无症状绝经后妇女的 ET 测量结果。其中，1758 例 ET<5mm，EC、EH 和 EP 的概率分别为 0.284%（5/1758）、0.398%（7/1758）和 0.626%（11/1758）。在另外 1862 例 ET≥5mm 的病例中，EC、EH 和 EP 的概率分别为 1.128%（21/1862）、1.128%（21/1862）和 1.557%（29/1862）。结果表明，ET 可作为预测 EC 和其他病理变化的危险因素。
这项荟萃分析的结果表明，当 ET 大于 5mm 时，EC、EH 和 EP 的发生率显著增加。因此，在无症状绝经后妇女中，使用 ET 作为 EC 和 EH 的筛查试验是合理的。
