Threshold for endometrial sampling among postmenopausal patients without vaginal bleeding

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• 作者：Michelle Louie ; ^{louiemy@upmc.edu" class="auth_mail" title="E-mail the corresponding author} ; Timothy P. Canavan ; Suketu Mansuria
• 关键词：Asymptomatic ; Biopsy sampling ; Endometrial cancer ; Endometrial hyperplasia ; Incidental ; Postmenopausal ; Thickened endometrial lining
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：132
• 期：3
• 页码：314-317
• 全文大小：169 K

文摘

To provide an optimum threshold for endometrial biopsy sampling among postmenopausal women without vaginal bleeding and an incidentally-found endometrial lining of above 4 mm.

Methods

A cohort of postmenopausal women (aged ≥ 50 years) who underwent pelvic ultrasonography at a tertiary US hospital for indications other than vaginal bleeding was retrospectively evaluated. Women were included if they had an endometrial lining of above 4 mm. Logistic regression was performed to determine the probability of endometrial carcinoma and atypical hyperplasia at each increasing millimeter of endometrial thickness from 4 to 20 mm.

Results

Among 462 women, carcinoma was identified in 9 (1.9%) and atypical hyperplasia in 7 (1.5%). An endometrial thickness of or above 14 mm was significantly associated with atypical hyperplasia (odds ratio 4.29; 95% confidence interval 1.30–14.20; P = 0.02), with a negative predictive value of 98.3%. A thickness of or above 15 mm was associated with carcinoma (odds ratio 4.53; 95% confidence interval 1.20–17.20; P = 0.03), with a negative predictive value of 98.5% and a 0.06% risk of cancer.

Conclusion

Irrespective of conventional risk factors, an incidentally-found thickened endometrial lining of less than 15 mm might not warrant endometrial biopsy sampling among postmenopausal women without vaginal bleeding.