Tsuda H, Kawabata M, Kawabata K, Yamamoto K, Umesaki N
Department of Obstetrics and Gynecology, Osaka City General Hospital, Japan.
Gynecol Oncol. 1997 Jan;64(1):35-7. doi: 10.1006/gyno.1996.4461.
Transvaginal ultrasonography (TVS) is considered useful for identifying endometrial malignancies, but it has a low specificity and a high false-positive rate. The purpose of this study was to improve the specificity of this technique. A total of 300 postmenopausal women were studied. They were clinically evaluated by TVS and endometrial histology. Twenty women yielded pathologic findings on endometrial examination. The mean endometrial thickness was related to the length of time since menopause. For endometria with pathological findings, sonographic measurements of endometria with a thickness of greater than 3 mm exhibited 95.0% sensitivity, 68.5% specificity, 19.4% positive predictive value, and 99.4% negative predictive value. If a 4-mm cutoff limit was used for < 5 years since menopause and a 3-mm cutoff limit was used for > or = 5 years since menopause, 95.0% sensitivity, 78.1% specificity, 25.7% positive predictive value, and 99.5% negative predictive value were obtained. The specificity and false-positive rate were improved when the cutoff limit was decided based on the length of time since menopause. The cutoff level of the endometrial thickness for detection of endometrial malignancies should be decided based on the length of time since menopause.
经阴道超声检查（TVS）被认为有助于识别子宫内膜恶性肿瘤，但它特异性低且假阳性率高。本研究的目的是提高该技术的特异性。共对300名绝经后女性进行了研究。她们接受了TVS和子宫内膜组织学的临床评估。20名女性在子宫内膜检查中发现了病理结果。子宫内膜平均厚度与绝经时间长短有关。对于有病理结果的子宫内膜，厚度大于3mm的子宫内膜超声测量显示出95.0%的敏感性、68.5%的特异性、19.4%的阳性预测值和99.4%的阴性预测值。如果绝经时间小于5年采用4mm的截断值，绝经时间大于或等于5年采用3mm的截断值，则敏感性为95.0%、特异性为78.1%、阳性预测值为25.7%、阴性预测值为99.5%。根据绝经时间长短确定截断值时，特异性和假阳性率得到了提高。检测子宫内膜恶性肿瘤的子宫内膜厚度截断水平应根据绝经时间长短来确定。
