Endometrial thickness cut-off value by transvaginal ultrasonography for screening of endometrial pathology in premenopausal and postmenopausal women
10.5468/ogs.2019.62.6.445
- Author:
Yu Ran PARK
1
;
Shin Wha LEE
;
Yeongsin KIM
;
In Young BAE
;
Hong Kyu KIM
;
Jaewon CHOE
;
Yong Man KIM
Author Information
1. Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Diagnosis;
Endometrium;
Endometrial hyperplasia;
Endometrial neoplasms
- MeSH:
Biopsy;
Chungcheongnam-do;
Cohort Studies;
Diagnosis;
Endometrial Hyperplasia;
Endometrial Neoplasms;
Endometrium;
Female;
Humans;
Hyperplasia;
Incidental Findings;
Lost to Follow-Up;
Mass Screening;
Myoma;
Pathology;
Polyps;
Retrospective Studies;
Sensitivity and Specificity;
Ultrasonography
- From:Obstetrics & Gynecology Science
2019;62(6):445-453
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To assess the clinical usefulness and diagnostic accuracy of ultrasonographic measurement of endometrial thickness (ET) in women with endometrial hyperplasia or cancer (EH+). METHODS: This retrospective cohort study included 29,995 consecutive women who underwent transvaginal ultrasonography (TVS) for an incidental finding of a thickened endometrium at the health screening and promotion center at Asan Medical Center between 2006 and 2010. Among 959 patients with endometrial abnormalities, 92 patients were included in this study. A total of 867 patients were excluded: 416 were lost to follow-up; 263 did not undergo endometrial biopsy; 155 had endometrial polyps; 17 had submucosal myomas; and 16 had insufficient tissue samples. Endometrial histology was the reference standard for calculating accuracy. RESULTS: Of the 92 patients, 78 (84.8%) had normal pathology, while 14 (15.2%) had endometrial pathology (EH+), including 5 patients (35.7%) with simple hyperplasia without atypia, 3 (21.4%) with complex hyperplasia, and 6 (42.9%) with endometrial carcinoma, all stage Ia. The area under the receiver-operating characteristic curve was 0.75 (95% confidence interval [CI], 0.593–0.906). The cut-off value for ET was 8 mm, indicating that TVS ET had a fair accuracy in diagnosing carcinoma, had a sensitivity of 100% (95% CI, 62.9–100.0%) and a specificity of 24.3% (95% CI, 15.2–36.3%). CONCLUSION: TVS is useful for detecting EH+, with a cut-off value for ET of 8 mm having a high sensitivity for detecting endometrial pathologies and the ability to identify women highly unlikely to have EH+, thereby avoiding more invasive endometrial biopsy.
