GENERAL OBJECTIVE: To determine endometrial cancer risk among patients with abnormal uterine bleeding based on the International Endometrial Tumor Analysis (IETA) features.
SPECIFIC OBJECTIVES: 1. To described the profile of patients with AUB suspected of having endometrial pathology; 2. To describe sonologic features of patients with AUB suspected of endometrial cancer using IETA features; and 3. To determine the association of a scoring system and endometrial cancer risk.
METHODS: We prospectively studied 542 participants who came in the CWCU of CSMC with a diagnosis of AUB from July 1, 2016 to December 31, 2016. We excluded patients with endometrial thickness of less than 4 mm on gray-scale sonography, those with technical difficulties in assessing the endometrium such as in cases of very large myomas, absence of histopathological diagnosis, and those whose sampling was done as an office procedure. A total of 98 participants were included, 89 (90.8%) had benign pathologies and 9 (9.2%) were malignant. Patient characteristics including, age, gravidity, BMI, medical history, and endometrial assessment using IETA were tabulated with each characteristic given a score of 0-3 depending on the degree of risk factor. Percentages, Pearson Chi-square Test with corresponding P-value and ROC curve analysis were performed.
RESULTS: The best predictors for endometrial cancer were age more than 50 years, nulligravid, BMI of more than 25, and presence of hypertension and diabetes mellitus. Sonographic features based on IETA showed an endometrial thickness of more than 20mm, irregular endometrial-myometrial junction, heterogenous endometrium, presence of multiple and large vessels on doppler analysis, contributed to endometrial cancer risk. These variables were used to create a scoring system with an area under the curve of 0.974 giving the best cut-off value of more than or equal to 9, with 100% sensitivity and 89% specificity.
CONCLUSION: Among patients with abnormal uterine bleeding and endometrial thickness of more than 4mm, we can predict the risk for endometrial cancer and aid the clinician in decision making on who may be managed conservatively or aggressively based on the value obtained from the scoring system. The study, however, needs to be validated prior to use in clinical practice.

Human ; Female ; Adult ; Gravidity ; Body Mass Index ; Endometrium ; Endometrial Neoplasms ; Myoma ; Uterine Neoplasms ; Uterine Hemorrhage ; Diabetes Mellitus ; Hypertension ; Decision Making

OBJECTIVE: This is a prospective case control study which aimed to determine the correlation of ovarian volume measurements with endometrial tissue diagnosis such as benign, premalignant and malignant conditions in women with postmenopausal bleeding.

METHODS: Thirty four postmenopausal women with bleeding underwent transvaginal ultrasound for ovarian volume measurements prior to dilatation and curettage. The presence of benign (Group I), premalignant and malignant endometrial. conditions (Group II) were correlated with ovarian volume.

RESULTS: Mean endometrial stripe thickness for group I (N= 19; 1.16ml+/- SD 0.88ml) was not significantly different from group II (N = 15; 1.58ml +/- SD 0.53ml). Mean ovarian volume among patients with premalignant and malignant histology (5.70ml +/- SD 1.91ml) was significantly higher than those with benign histology (2.04ml +/- SD?1.10ml) (P = 0.023). Linear regression analysis showed an association between ovarian volume and premalignant and malignant endometrial conditions (P=0.000). Using the mean ovarian volume cut-off of 5.8ml for postmenopausal women with bleeding, the sensitivity, specificity, positive predictive value and negative predictive value for premalignant and malignant endometrial conditions were 100%, 67.87%,40% and 100%,respectively.

CONCLUSION: Large ovaries among postmenopausal women may represent a marker of risk for endometrial cancer and may be used as an adjunct to endometrial thickness in ruling endometrial malignancy.

Human ; Female ; Aged ; Middle Aged ; Adult ; Postmenopause ; Ovary ; Dilatation And Curettage ; Uterine Hemorrhage ; Endometrial Neoplasms ; Uterine Diseases

GENERAL OBJECTIVE: To determine endometrial cancer risk among patients with abnormal uterine bleeding based on the International Endometrial Tumor Analysis (IETA) features.
SPECIFIC OBJECTIVES: 1. To described the profile of patients with AUB suspected of having endometrial pathology; 2. To describe sonologic features of patients with AUB suspected of endometrial cancer using IETA features; and 3. To determine the association of a scoring system and endometrial cancer risk.
METHODS: We prospectively studied 542 participants who came in the CWCU of CSMC with a diagnosis of AUB from July 1, 2016 to December 31, 2016. We excluded patients with endometrial thickness of less than 4 mm on gray-scale sonography, those with technical difficulties in assessing the endometrium such as in cases of very large myomas, absence of histopathological diagnosis, and those whose sampling was done as an office procedure. A total of 98 participants were included, 89 (90.8%) had benign pathologies and 9 (9.2%) were malignant. Patient characteristics including, age, gravidity, BMI, medical history, and endometrial assessment using IETA were tabulated with each characteristic given a score of 0-3 depending on the degree of risk factor. Percentages, Pearson Chi-square Test with corresponding P-value and ROC curve analysis were performed.
RESULTS: The best predictors for endometrial cancer were age more than 50 years, nulligravid, BMI of more than 25, and presence of hypertension and diabetes mellitus. Sonographic features based on IETA showed an endometrial thickness of more than 20mm, irregular endometrial-myometrial junction, heterogenous endometrium, presence of multiple and large vessels on doppler analysis, contributed to endometrial cancer risk. These variables were used to create a scoring system with an area under the curve of 0.974 giving the best cut-off value of more than or equal to 9, with 100% sensitivity and 89% specificity.
CONCLUSION: Among patients with abnormal uterine bleeding and endometrial thickness of more than 4mm, we can predict the risk for endometrial cancer and aid the clinician in decision making on who may be managed conservatively or aggressively based on the value obtained from the scoring system. The study, however, needs to be validated prior to use in clinical practice.

Human ; Female ; Adult ; Gravidity ; Body Mass Index ; Endometrium ; Endometrial Neoplasms ; Myoma ; Uterine Neoplasms ; Uterine Hemorrhage ; Diabetes Mellitus ; Hypertension ; Decision Making