Diagnosis of postmenopausal endometrial pathology by vaginal ultrasonography

Özet

Vaginal ultrasonografi ile endometrial kalınlık ölçülmesinin postmenapozal kadınlarda histopatolojik tanıyla olan korelasyonu ve endometrial karsinomanın tanısmdaki duyarlılığı araştırıldı. Postmenopozal dönemde olan vaginal kanamalı 100 kadına ve asemptomatik 76 kadına vaginal ultrasonografi ile endometrial kalınlık ölçümü uygulandı. Daha sonra tüm bireylerden endometrial biyopsi alındı ve tek bir patolog tarafından değerlendirildi. Çalışmanın sonucunda postmenapozal kanaması olan hastalarda vaginal ultrasonografi ile ölçülen endometrial kalınlık 5mmden az ise endometrial biyopsi alınmasının gerekli olmadığı görüşüne varıldı.

Abstract

OBJECTIVE: The aim of this study is to show the correlation between vaginal ultrasonographic findings and endometrial histopathology and the sensitivity of this tecnique in diagnosis of endometrial carcinoma in postmenopausal women. STUDY DESIGN: A prospective randomised clinical trial was performed on 176 postmenopausal patients at Department of Obstetrics and Gynecology, Besançon Hospital, Besançon, France, between February 1991 and May 1992. There were two groups; asymptomatic patients and women with bleeding. All were examined by ultrasonography with a vaginal probe, ariftafter that endometrial biopsy was done. , Histologic specimens were evaluated by a single pathologist. For statistical analysis chi square and student t test was applied where appropriate. RESULTS: Ahundred of women had postmenopausal bleeding (56%) and others (44%) were asymptomatic. Ninety-two of 176 postmenopausal patients had endometrial thickness over 5 mm and 64 of 92 (%69) had vaginal bleeding. We have also determined endometrial carcinoma in 41 of patients by histologic detection. We have not observed any cancer case in patients whose endometrial thickness were less than 5 mm. CONCLUSION: During menopause, if the endometrial thickness of patients with bleeding is 5 mm, a biopsy curettage should be performed immediately for histologic evaluation, but if the thickness is 5 mm, no other intervention which increases the cost is necessary.