Obstet Gynecol Sci.  2019 Jul;62(4):273-279. 10.5468/ogs.2019.62.4.273.

The significance of sonographically thickened endometrium in asymptomatic postmenopausal women

• Ozelci R
• Dilbaz B
• Akpınar F
• Kınay T
• Baser E
• Aldemir O
• Altınbas

• KMID: 2451657
• DOI: http://doi.org/10.5468/ogs.2019.62.4.273

Abstract

OBJECTIVE
To investigate the correlation between sonographic, hysteroscopic, and pathological findings in postmenopausal asymptomatic patients with sonographically thickened endometrium.
METHODS
The records of postmenopausal patients who attended the Menopause Outpatient Clinic of a tertiary women's hospital in Ankara, Turkey between January 1, 2012 and December 15, 2013 were retrieved. A total of 266 postmenopausal women without vaginal bleeding underwent hysteroscopic evaluation and endometrial sampling. Patients whose pathological records indicated an endometrial thickness equal to or greater than 6 mm (double layer) on transvaginal ultrasonography without any symptoms were included in the study.
RESULTS
The most frequently detected focal intrauterine lesions in asymptomatic women were endometrial polyps, which were diagnosed in 168 (63.1%) cases. Twenty-four (9%) patients were diagnosed as having simple hyperplasia, 4 (1%) atypical hyperplasia, and 8 (3%) endometrial adenocarcinoma. Two of the patients with adenocarcinoma were diagnosed based on endometrial polyps, and 6 cases showed endometrial hyperplasia on hysteroscopy, while histological examination showed endometrial carcinoma.
CONCLUSION
We suggest 10.5 mm as the cutoff value for endometrial thickness and recommend hysteroscopy following dilatation and curettage to increase diagnostic efficacy and provide definitive treatment in asymptomatic postmenopausal women with thickened endometrium.

Keyword

Postmenopause; Endometrium; Endometrium cancer; Hysteroscopy

MeSH Terms

Adenocarcinoma
Ambulatory Care Facilities
Dilatation and Curettage
Endometrial Hyperplasia
Endometrial Neoplasms
Endometrium*
Female
Humans
Hyperplasia
Hysteroscopy
Menopause
Polyps
Postmenopause
Turkey
Ultrasonography
Uterine Hemorrhage

Figure

• 

  Fig. 1 Receiver operating characteristic (ROC) curves analysing the optimal cut-off value for premalignant and malignant lesions. Endometrial thickness in premalignant and malignant lesion prediction (area under the receiver operating characteristic curve=0.740; P=0.01; 95% confidence interval, 0.66–0.81).

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