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Nguyen, P. N., Nguyen, V. T., Nguyen, T. T. N., Nguyen, T. D. T., Nguyen, T. N. T., Truong, T. T. T., & Dinh, T. P. M. (2022). Value of endometrial thickness in predicting endometrial cancer in perimenopausal and postmenopausal women with abnormal uterine bleeding . Vietnam Journal of Obstetrics & Gynecology, 19(3), 31-38. https://doi.org/10.46755/vjog.2021.3.1268
Abstract
Objective: To determine the value of endometrial thickness in predicting endometrial cancer in perimenopausal and postmenopausal women with abnormal uterine bleeding (AUB).
Methods: Women aged 40 years to postmenopause with AUB was investigated by transvaginal ultrasound and had histopathological results for comparison.
Results: Endometrial thickness in the malignant group was significantly thicker than in the benign group (23.99 ± 10.58 mm vs 12.7 ± 7.53, p < 0.01). Endometrial thickness had a good value as a predictor of endometrial cancer in postmenopausal women with AUC: 0.89, 95% CI: 0.79 – 0.99, p < 0.01. Using threshold of endometrial thickness greater than 15.5 mm had the sensitivity and the specificity were 100%, 95.7% in women with postmenopausal period under 5 years. Conversely, in women with postmenopausal period greater than 5 years, using threshold of endometrial thickness more than 11.7 mm had the sensitivity and the specificity were 90.9%, 76.9%.
Conclusion: Endometrial thickness contributes to help in differentiating malignant from benign endometrial pathologies in perimenopausal and postmenopausal women with AUB. In postmenopausal women, endometrial thickness is a good tool for predicting endometrial cancer.
References
TÀI LIỆU THAM KHẢO
1. ACOG. "Diagnosis of abnormal uterine bleeding in reproductive-aged women". Practice Bulletin. 2012;128.
2. Hoffman.B.L SJO, Schaffer.J.I, Halvorson.L.M, Bradshaw.K.D, Cunningham.F.G,. " Abnormal uterine bleeding", "Pelvic mass", "Menopausal transition", " Endometrial cancer", Williams Gynecology,. 2nd ed. Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas: McGrawHill Medical; 2012.
3. Munro.M.G, Critchley.H.O, Broder.M.S, Fraser. I. S. "FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age". International Journal of Gynecology and Obstetrics. 2011;113(1):3-13.
4. Marina.D PT, Sophia.B, Alexandros.D, Vasileios.L, Georgios.M, Alexander.T.T Clinical evaluation of women with PMB. Is it always necessary an endometrial biopsy to be performed? A review of the literature GENERAL GYNECOLOGY 2011;283:261-6.
5. Meena.N, Rekha.R. "Role of Hysteroscopy in Diagnostic Evaluation of Intrauterine Causes of Abnormal Uterine Bleeding Compared to Pathology Reports". Journal of Dental and Medical Sciences. 2017;16(9):pp. 46-52.
6. Kotdawala.P, Kotdawala.S, Nagar.N. "Evaluation of endometrium in peri-menopausal abnormal uterine bleeding". Journal of mid-life health. 2013;4(1):16-21.
7. Stachowicz. N, Mazurek. D, Łoziński. T, Czekierdowski. A. "Diagnostic hysteroscopy and the risk of malignant cells intraabdominal spread in women with endometrial cancer". Ginekologia Polska. 2017;88(10):562-7.
8. Catala.L, Lacoeuille.C.L, Sentilhès.L, Mezzadri.M, Simon.G, Jeanneret.C, et al. "Hyperplasie de l'endomètre et stades précoces du cancer de l'endomètre. Reste-t-il des indications au curetage ?". Paris: Collège National Des Gynécologues et Obstériciens FranÇais; 2008. pp. 239-52 p.
9. Azmy.O.M, Haitham.B. "Ultrasound imaging of endometrial cancer", Gynecologic neoplasia. Ultrasonography in Gynecology. Cambridge: Cambridge University Press; 2014. p. pp. 224-32.
10. ACOG. "The Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Women With Postmenopausal Bleeding". The Role of Transvaginal Ultrasonography. 2018;131(5):e124-e9.
11. Gilles Grangé, Frédéric Bargy. " Échographie gynécologique pelvienne", " Pathologies utérines et endométriales", Guide pratique de l'échographie obstétricale et gynécologie,. 2 ed. Paris: Elsevier Masson; 2016.
12. Leone.F. P, Timmerman. D, Bourne. T, Valentin. L, Epstein.E, Goldstein. S. R, et al. "Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion from the International Endometrial Tumor Analysis (IETA) group". Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2010;35(1):103-12.
13. Develioglu.O.H, Bilgin.T, Yalcin.O.T, Özalp.S. "Transvaginal ultrasonography and uterine artery Doppler in diagnosing endometrial pathologies and carcinoma in postmenopausal bleeding". Archives of gynecology and obstetrics. 2003;268:175-80.
14. Mayuri.M, Abha.S, Narula M.K. "Role Of Transvaginal Sonography, Power Doppler And Hysteroscopy In Women With Abnormal Uterine Bleeding: A Comparative Study". Journal of Dental and Medical Sciences. 2014;13(11):pp. 82-9.
15. AboulFotouh.E.M. "Transvaginal power Doppler sonography can discriminate between benign and malignant endometrial conditions in women with postmenopausal bleeding". Middle East Fertility Society Journal. 2012;17:22-9.
16. Li.Z, Li.L. "Risk of malignancies among asymptomatic postmenopausal women with thickened endometrium: A cohort study". Medicine. 2019;98(6):e14464.
17. Sherif.A, Ramy.A.R M, M Zeid.R.M. "Study of Endometrial Volume and Vascularity by 3D Power Doppler Ultrasound in Women with Perimenopausal Bleeding". Investigations in Gynecology Research & Womens Health. 2017;1(1):pp. 1-8.
18. De Smet.F, De Brabanter.J, Van Den Bosch.T, Pochet.N AF, Van Holsbeke.C, Moerman.P, et al. "New models to predict depth of infiltration in endometrial carcinoma based on transvaginal sonography". Ultrasound Obstetrics Gynecology. 2006;27:664-71.
19. Epstein E, Fischerova D, Valentin L, Testa AC, Franchi D, Sladkevicius P, et al. Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study. Ultrasound Obstet Gynecol. 2018;51(6):pp. 818-28.
20. Rahmani.M, Heydari.S, Mousavi.A, Ahmadinejad.N, Azhdeh.S, Shakiba.M. Accuracy of Imaging in Preoperative Local Staging of Endometrial Cancer: Could Imaging Predict Low Risk Patients? International Journal of Women's Health and Reproduction Sciences. 2018;6:363-8.
21. Getpook.C WS. "Endometrial thickness screening in premenopausal women with abnormal uterine bleeding". Journal of Obstetrics and Gynaecology Research. 2006;32(6):588-92.
22. Cogendez.E, Kaygusuz.E.I, Eken.M.K, Karateke.A, Bakal.N, Gun.I. "The role of transvaginal power Doppler ultrasound in the differential diagnosis of benign intrauterine focal lesions". Journal of Medical Ultrasonics. 2015.
23. AbdelMaboud.N.M, Elsaid.H.H. "Role of transvaginal ultrasonography and colour Doppler in the evaluation of postmenopausal bleeding". The Egyptian Journal of Radiology and Nuclear Medicine 2015;46:235-43.
24. Ferrazzi.E, Torri.V, Trio.D, Zannoni.E, Filiberto.S, Dordoni.D. "Sonographic endometrial thickness: a useful test to predict atrophy in patients with postmenopausal bleeding. An Italian multicenter study". Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1996;7(5):315-21.
25. Bano.I, Mittal.G, Khalid.M, Akhtar.N, Arshad.Z. "A Study of Endometrial Pathology by Transvaginal Color Doppler Ultrasonography and its Correlation with Histopathology in Post-menopausal Women". Indian Medical Gazette. 2013:134-8.
26. Arslan.M, Erdem.A, Erdem.M, Yazicia.G, Himmetoglub.O, Gursoy.R. "Transvaginal color Doppler ultrasonography for prediction of pre-cancerous endometrial lesions". International Journal of Gynecology and Obstetrics. 2003:299-306.
27. Sladkevicius.P, Valentin.L, and Marsal.K. "Endometrial thickness and Doppler velocimetry of the uterine arteries as discriminators of endometrial status in women with postmenopausal bleeding: A comparative study". American Journal of Obstetrics & Gynecology. 1994;171(3):723-8.
28. Breijer.M.C, Timmermans.A, Van Doorn.H.C, Mol.B.W.J, Opmeer.B.C. "Diagnostic Strategies for Postmenopausal Bleeding". Obstetrics and Gynecology International. 2010;2019.
29. Tsuda.H, Ito.Y.M, Todo.Y, Iba.T, Tasaka.K, Sutou.Y et al. "Measurement of endometrial thickness in premenopausal women in office gynecology". Reproductive Medicine and Biology. 2018;17:29-35.
30. Ngô Lê Phương Thảo, Nguyễn Ngọc Thoa. "Giá trị của siêu âm trong đánh giá tăng sinh nội mạc ở tuổi quanh mãn kinh". Tạp chí Y Học TP Hồ Chí Minh. 2005;9(1):tr.160-6.
31. Farquhar.C, Ekeroma.A, Furness.S, Arroll.B. "A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women". Acta Obstetricia et Gynecologica Scandinavica. 2003;82(493-504).
32. Palmer.J.E, Perunovic.B, Tidy.J.A. "Review Endometrial hyperplasia". The Obstetrician & Gynaecologist. 2008;10:211-6.
33. Kim.M.J KJJ, Kim.S.M. Endometrial evaluation with transvaginal ultrasonography for the screening of endometrial hyperplasia or cancer in premenopausal and perimenopausal women. Korean Society of Obstetrics and Gynecology. 2016;59(3):192-200.
34. Özdemir.S, Çelik.Ç, Gezginç, KÂreoi.D, Esen.H. "Evaluation of endometrial thickness with transvaginal ultrasonography and histopathology in premenopausal women with abnormal vaginal bleeding". Archives of gynecology and obstetrics. 2010;282:395-9.
1. ACOG. "Diagnosis of abnormal uterine bleeding in reproductive-aged women". Practice Bulletin. 2012;128.
2. Hoffman.B.L SJO, Schaffer.J.I, Halvorson.L.M, Bradshaw.K.D, Cunningham.F.G,. " Abnormal uterine bleeding", "Pelvic mass", "Menopausal transition", " Endometrial cancer", Williams Gynecology,. 2nd ed. Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas: McGrawHill Medical; 2012.
3. Munro.M.G, Critchley.H.O, Broder.M.S, Fraser. I. S. "FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age". International Journal of Gynecology and Obstetrics. 2011;113(1):3-13.
4. Marina.D PT, Sophia.B, Alexandros.D, Vasileios.L, Georgios.M, Alexander.T.T Clinical evaluation of women with PMB. Is it always necessary an endometrial biopsy to be performed? A review of the literature GENERAL GYNECOLOGY 2011;283:261-6.
5. Meena.N, Rekha.R. "Role of Hysteroscopy in Diagnostic Evaluation of Intrauterine Causes of Abnormal Uterine Bleeding Compared to Pathology Reports". Journal of Dental and Medical Sciences. 2017;16(9):pp. 46-52.
6. Kotdawala.P, Kotdawala.S, Nagar.N. "Evaluation of endometrium in peri-menopausal abnormal uterine bleeding". Journal of mid-life health. 2013;4(1):16-21.
7. Stachowicz. N, Mazurek. D, Łoziński. T, Czekierdowski. A. "Diagnostic hysteroscopy and the risk of malignant cells intraabdominal spread in women with endometrial cancer". Ginekologia Polska. 2017;88(10):562-7.
8. Catala.L, Lacoeuille.C.L, Sentilhès.L, Mezzadri.M, Simon.G, Jeanneret.C, et al. "Hyperplasie de l'endomètre et stades précoces du cancer de l'endomètre. Reste-t-il des indications au curetage ?". Paris: Collège National Des Gynécologues et Obstériciens FranÇais; 2008. pp. 239-52 p.
9. Azmy.O.M, Haitham.B. "Ultrasound imaging of endometrial cancer", Gynecologic neoplasia. Ultrasonography in Gynecology. Cambridge: Cambridge University Press; 2014. p. pp. 224-32.
10. ACOG. "The Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Women With Postmenopausal Bleeding". The Role of Transvaginal Ultrasonography. 2018;131(5):e124-e9.
11. Gilles Grangé, Frédéric Bargy. " Échographie gynécologique pelvienne", " Pathologies utérines et endométriales", Guide pratique de l'échographie obstétricale et gynécologie,. 2 ed. Paris: Elsevier Masson; 2016.
12. Leone.F. P, Timmerman. D, Bourne. T, Valentin. L, Epstein.E, Goldstein. S. R, et al. "Terms, definitions and measurements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion from the International Endometrial Tumor Analysis (IETA) group". Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2010;35(1):103-12.
13. Develioglu.O.H, Bilgin.T, Yalcin.O.T, Özalp.S. "Transvaginal ultrasonography and uterine artery Doppler in diagnosing endometrial pathologies and carcinoma in postmenopausal bleeding". Archives of gynecology and obstetrics. 2003;268:175-80.
14. Mayuri.M, Abha.S, Narula M.K. "Role Of Transvaginal Sonography, Power Doppler And Hysteroscopy In Women With Abnormal Uterine Bleeding: A Comparative Study". Journal of Dental and Medical Sciences. 2014;13(11):pp. 82-9.
15. AboulFotouh.E.M. "Transvaginal power Doppler sonography can discriminate between benign and malignant endometrial conditions in women with postmenopausal bleeding". Middle East Fertility Society Journal. 2012;17:22-9.
16. Li.Z, Li.L. "Risk of malignancies among asymptomatic postmenopausal women with thickened endometrium: A cohort study". Medicine. 2019;98(6):e14464.
17. Sherif.A, Ramy.A.R M, M Zeid.R.M. "Study of Endometrial Volume and Vascularity by 3D Power Doppler Ultrasound in Women with Perimenopausal Bleeding". Investigations in Gynecology Research & Womens Health. 2017;1(1):pp. 1-8.
18. De Smet.F, De Brabanter.J, Van Den Bosch.T, Pochet.N AF, Van Holsbeke.C, Moerman.P, et al. "New models to predict depth of infiltration in endometrial carcinoma based on transvaginal sonography". Ultrasound Obstetrics Gynecology. 2006;27:664-71.
19. Epstein E, Fischerova D, Valentin L, Testa AC, Franchi D, Sladkevicius P, et al. Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study. Ultrasound Obstet Gynecol. 2018;51(6):pp. 818-28.
20. Rahmani.M, Heydari.S, Mousavi.A, Ahmadinejad.N, Azhdeh.S, Shakiba.M. Accuracy of Imaging in Preoperative Local Staging of Endometrial Cancer: Could Imaging Predict Low Risk Patients? International Journal of Women's Health and Reproduction Sciences. 2018;6:363-8.
21. Getpook.C WS. "Endometrial thickness screening in premenopausal women with abnormal uterine bleeding". Journal of Obstetrics and Gynaecology Research. 2006;32(6):588-92.
22. Cogendez.E, Kaygusuz.E.I, Eken.M.K, Karateke.A, Bakal.N, Gun.I. "The role of transvaginal power Doppler ultrasound in the differential diagnosis of benign intrauterine focal lesions". Journal of Medical Ultrasonics. 2015.
23. AbdelMaboud.N.M, Elsaid.H.H. "Role of transvaginal ultrasonography and colour Doppler in the evaluation of postmenopausal bleeding". The Egyptian Journal of Radiology and Nuclear Medicine 2015;46:235-43.
24. Ferrazzi.E, Torri.V, Trio.D, Zannoni.E, Filiberto.S, Dordoni.D. "Sonographic endometrial thickness: a useful test to predict atrophy in patients with postmenopausal bleeding. An Italian multicenter study". Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 1996;7(5):315-21.
25. Bano.I, Mittal.G, Khalid.M, Akhtar.N, Arshad.Z. "A Study of Endometrial Pathology by Transvaginal Color Doppler Ultrasonography and its Correlation with Histopathology in Post-menopausal Women". Indian Medical Gazette. 2013:134-8.
26. Arslan.M, Erdem.A, Erdem.M, Yazicia.G, Himmetoglub.O, Gursoy.R. "Transvaginal color Doppler ultrasonography for prediction of pre-cancerous endometrial lesions". International Journal of Gynecology and Obstetrics. 2003:299-306.
27. Sladkevicius.P, Valentin.L, and Marsal.K. "Endometrial thickness and Doppler velocimetry of the uterine arteries as discriminators of endometrial status in women with postmenopausal bleeding: A comparative study". American Journal of Obstetrics & Gynecology. 1994;171(3):723-8.
28. Breijer.M.C, Timmermans.A, Van Doorn.H.C, Mol.B.W.J, Opmeer.B.C. "Diagnostic Strategies for Postmenopausal Bleeding". Obstetrics and Gynecology International. 2010;2019.
29. Tsuda.H, Ito.Y.M, Todo.Y, Iba.T, Tasaka.K, Sutou.Y et al. "Measurement of endometrial thickness in premenopausal women in office gynecology". Reproductive Medicine and Biology. 2018;17:29-35.
30. Ngô Lê Phương Thảo, Nguyễn Ngọc Thoa. "Giá trị của siêu âm trong đánh giá tăng sinh nội mạc ở tuổi quanh mãn kinh". Tạp chí Y Học TP Hồ Chí Minh. 2005;9(1):tr.160-6.
31. Farquhar.C, Ekeroma.A, Furness.S, Arroll.B. "A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women". Acta Obstetricia et Gynecologica Scandinavica. 2003;82(493-504).
32. Palmer.J.E, Perunovic.B, Tidy.J.A. "Review Endometrial hyperplasia". The Obstetrician & Gynaecologist. 2008;10:211-6.
33. Kim.M.J KJJ, Kim.S.M. Endometrial evaluation with transvaginal ultrasonography for the screening of endometrial hyperplasia or cancer in premenopausal and perimenopausal women. Korean Society of Obstetrics and Gynecology. 2016;59(3):192-200.
34. Özdemir.S, Çelik.Ç, Gezginç, KÂreoi.D, Esen.H. "Evaluation of endometrial thickness with transvaginal ultrasonography and histopathology in premenopausal women with abnormal vaginal bleeding". Archives of gynecology and obstetrics. 2010;282:395-9.
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