Predictive value of three-dimensional energy ultrasound for endometrial cancer in women with postmenopausal bleeding
- Author:
Li WANG
1
Author Information
- Publication Type:Journal Article
- Keywords: Endometrial cancer; Flow index; Ovarian cyst; Postmenopausal bleeding; Predictive value
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2019;40(6):954-958
- CountryChina
- Language:Chinese
- Abstract: Objective: To explore the predictive value of three-dimensional energy Doppler ultrasound for endometrial cancer (EC) in women with postmenopausal hemorrhage (PMB) so as to analyze the relationship between ovarian cyst and the risk of endometrial lesions. Methods: We selected 386 women with PMB diagnosed at The First Affiliated Hospital of Xi'an Jiaotong university from October 2015 to October 2018. The predictive value of endometrial thickness (ET), endometrial volume (EV), vascularization index (VI), flow index (FI) and vascularization flow index (VFI) for EC were analyzed according to the results of endometrial pathology. And the risk of endometrial lesions was compared between patients with ovarian cyst and those without ovarian cyst. Results: The pathological examination results of the 386 PMB women showed that normal endometrium accounted for 48.96%, benign endometrial lesions accounted for 40.93%, and EC accounted for 10.10%. ET, EV, VI, FI and VFI significantly differed between normal endometrial group, benign endometrial lesion group and EC group (P<0.05). Data of comparison between every two groups showed that the above indicators were significantly higher in EC group than in normal endometrial group and benign lesion group (P<0.05), and these indicators were significantly higher in benign endometrial group than normal endometrial group (P<0.05). Endometrial FI had the highest predictive value for EC (AUC=0.86), followed by VI (AUC=0.84) and VFI (AUC=0.82). ET has the smallest predictive value (AUC=0.74). The sensitivity (91.00%), specificity (85.00%), positive predictive value (85.85%) and negative predictive value (90.43%) of FI prediction were the highest, and the cutoff value was 29.36. There was no significant difference in comparison of AUC between every two indicators (P>0.05). ET, EV, VI, FI and VFI in women with PMB accompanied with ovarian cyst were significantly higher (P<0.05); the prevalence of endometrial hyperplasia without atypia (EH) or atypical endometrial hyperplasia (AEH) was significantly higher than that of women without ovarian cyst (P<0.05). Conclusion: The predictive value of three-dimensional energy Doppler ultrasound for EC in women with PMB is better than that of endometrial thickness; among them FI has the highest predictive value. Ovarian cyst may increase the risk of endometrial lesions in women with PMB, which is worthy of attention in clinic.
