Gull B, Karlsson B, Milsom I, Wikland M, Granberg S
Department of Obstetrics and Gynecology, University of Göteborg, East Hospital, Sweden.
Ultrasound Obstet Gynecol. 1996 May;7(5):322-7. doi: 10.1046/j.1469-0705.1996.07050322.x.
The aim of this study was to assess endometrial thickness using transvaginal sonography in a representative sample of postmenopausal women and to evaluate whether the technique can be used for screening of endometrial cancer. A random sample (n = 1000) of the total population of women aged 45-80 years resident in the city of Göteborg in 1993 was invited to attend for transvaginal sonography. The only exclusion criterion was hysterectomy. Transvaginal sonography was performed in 827 women. An endometrium of < or = 4 mm was not investigated further. Women with an endometrium of 5-7 mm and non-measurable cases were re-assessed 1 year later, and women with an endometrial thickness of > or = 8 mm were investigated directly with hysteroscopy and/or dilatation and curettage. A total of 559 women were postmenopausal and 183 were taking some form of hormonal substitution (33%). One case of endometrial cancer (endometrial thickness 19 mm), 23 cases of polyps without atypia (endometrial thickness 8-18 mm) and no cases of endometrial hyperplasia were diagnosed. Endometrial thicknesses were as follows (mean +/- SEM; respectively grouped as < or = 4 mm, 5-7 mm and > or = 8 mm): total population of postmenopausal women (3.4 +/- 0.1 mm, 82%, 13% and 6%); postmenopausal women without estrogens (3.0 +/- 0.1 mm, 90%, 7% and 3%); postmenopausal women on medium-potency estrogens + gestagen (5.1 +/- 0.3 mm, 49%, 40% and 11%) and women with low-potency estrogens only (3.6 +/- 0.3 mm, 85%, 6% and 9%). The prevalence of endometrial cancer was 0.2% and for benign polyps 3.2% in this representative sample of postmenopausal women. Our results do not support generalized endometrial screening with transvaginal sonography.
本研究的目的是使用经阴道超声检查评估绝经后女性代表性样本的子宫内膜厚度，并评估该技术是否可用于子宫内膜癌的筛查。邀请了1993年居住在哥德堡市的45 - 80岁女性总人口中的随机样本（n = 1000）参加经阴道超声检查。唯一的排除标准是子宫切除术。827名女性接受了经阴道超声检查。子宫内膜厚度≤4mm的女性不再进一步检查。子宫内膜厚度为5 - 7mm的女性和无法测量的病例在1年后重新评估，子宫内膜厚度≥8mm的女性直接接受宫腔镜检查和/或刮宫术。共有559名女性处于绝经后状态，183名正在接受某种形式的激素替代治疗（33%）。诊断出1例子宫内膜癌（子宫内膜厚度19mm），23例无 atypia的息肉（子宫内膜厚度8 - 18mm），未诊断出子宫内膜增生病例。子宫内膜厚度如下（平均值±标准误；分别分组为≤4mm、5 - 7mm和≥8mm）：绝经后女性总体（3.4±0.1mm，82%，13%和6%）；未使用雌激素的绝经后女性（3.0±0.1mm，90%，7%和3%）；接受中效雌激素 + 孕激素治疗的绝经后女性（5.1±0.3mm，49%，40%和11%）以及仅接受低效雌激素治疗的女性（3.6±0.3mm，85%，6%和9%）。在这个绝经后女性代表性样本中，子宫内膜癌的患病率为0.2%，良性息肉的患病率为3.2%。我们的结果不支持使用经阴道超声进行普遍的子宫内膜筛查。
