Obstet Gynecol Sci.  2016 May;59(3):192-200. 10.5468/ogs.2016.59.3.192.

Endometrial evaluation with transvaginal ultrasonography for the screening of endometrial hyperplasia or cancer in premenopausal and perimenopausal women

• Kim MJ
• Kim JJ
• Kim SM

• KMID: 2351784
• DOI: http://doi.org/10.5468/ogs.2016.59.3.192

Abstract

OBJECTIVE
The aim of our study is to determine clinical factors and sonographic findings associated with endometrial hyperplasia or cancer (EH+) in premenopausal and perimenopausal women.
METHODS
A total of 14,340 transvaginal ultrasonography examinations of 9,888 healthy premenopausal and perimenopausal women were included in this retrospective study. One hundred sixty-two subjects underwent endometrial biopsy based on abnormal uterine bleeding (AUB), sonographic endometrial abnormalities (thickened endometrium, endometrial mass, or endometrial stripe abnormality), or both. The clinical factors and sonographic endometrial abnormalities were evaluated with regard to EH+.
RESULTS
Histologically verified EH+ was found in fourteen subjects (8.6%); ten cases of endometrial hyperplasia (EH) without atypia, three cases of EH with atypia (AEH), and one case of endometrial cancer. Neither clinical factors nor AUB were associated with EH+ (P=0.32) or AEH+ (P=0.72). Of sonographic findings, endometrial stripe abnormality was significantly associated with EH+ (P=0.003) and marginally associated with AEH+ (P=0.05), but a thickened endometrium was not associated with EH+ (P=0.43).
CONCLUSION
Endometrial stripe abnormality is a significant factor to predict EH+ in healthy premenopausal and perimenopausal women with and without AUB. However, simple measurement of endometrial thickness has a limited role in this capacity.

Keyword

Diagnosis; Endometrial hyperplasia; Endometrial neoplasms; Transvaginal ultrasonography

MeSH Terms

Biopsy
Diagnosis
Endometrial Hyperplasia*
Endometrial Neoplasms
Endometrium
Female
Humans
Mass Screening*
Retrospective Studies
Ultrasonography*
Uterine Hemorrhage

Figure

• 

  Fig. 1 Eligible study population.

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