Clinical characteristics of endometrium in elder women and the diagnostic value of hysteroscopy
10.3760/cma.j.issn.0254-9026.2018.03.017
- VernacularTitle:老年女性子宫内膜病变特点及宫腔镜检查的诊断价值
- Author:
Qian HU
1
;
Lin LIANG
;
Fengli WU
;
Qiubo LYU
;
Fenghua WEI
Author Information
1. 100730,北京医院国家老年医学中心妇产科
- Keywords:
Hysteroscopy;
Endometrial;
Uterine hemorrhage
- From:
Chinese Journal of Geriatrics
2018;37(3):311-314
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of hysteroscopy in elder women with abnormal uterine bleeding (AUB) and asymptomatic postmenopausal women with a thickened endometrium.Methods Fifty-three cases in the AUB group and seventy-eight cases in the endometrial hyperplasia group underwent hysteroscopy examination and hysteroscopy-guided biopsy,then the hysteroscopic and histopathological results were compared between the two groups.Results Of the 131 cases,the normal endometrium accounted for 29.8% (n=39),endometrial polyp for 49.6% (n=65),submucous myomas for 4.6% (n=6),hyperplasia endometrii for 6.1%(n=8) and endometrial carcinoma for 9.9% (n=13).Both the AUB group and theendometrial hyperplasia group had 8 cases of endometrial carcinoma (15.1%,6.4%,respectively).For the diagnosis of normal endometrium with hysteroscopy,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) were 88%,97%,94% and 95%,respectively,in the AUB group,versus 82%,95%,86% and 93%,respectively,in the endometrial hyperplasia group.For the endometrial polyps,hysteroscopy showed a sensitivity,specificity,PPV and NPV of 100%,79%,74%,100%,respectively,in the AUB group and 98%,88%,92%,97%,respectively,in the endometrial hyperplasia group.For the endometrial cancer,hysteroscopy had a sensitivity,specificity,PPV and NPV of 75%,100%,100% and 96%,respectively,in the AUB group;while in the endometrial hyperplasia group,the sensitivity was 80%,the specificity and PPV were 100%,and the NPV was 99%.Conclusions In elder females,hysteroscopy allows for an accurate diagnosis in endometrial disease,and hysteroscopically directed sampling is mandatory,even if the uterine cavity appears normal at hysteroscopy,to rule out endometrial neoplasms.