The Comparing of Transvaginal Ultrasonography (TVS) Results with Dilatation and Curettage (D&C) Findings in Evaluation of Endometrial Cancer in Women with Postmenopausal Bleeding (PMB)

[摘要] BackgroundandObjective:Postmenopausalvaginalbleeding(PMB)isacommonandimportantclinicalproblem.PMBiscausedbyendometrialcancerinabout10%ofpatients.MostreportsindicatethatendometrialatrophyisthemostcommoncauseofPMB.Mostofthemformoreevaluationareadmittedfordilatationandcurettage(DC).Thepurposeofthisstudyistofindinwhichpatients,transvaginalultrasonography(TVS)canreplacewithDC?SubjectsandMethods:FromApril,2008,throughJune,2009,98womenwithPMBunderwentTVSandhistopathologicevaluationoftheendometriumafterDCorafterhysterectomy.Normalappearanceattransvaginalsonographywasdefinedasathin(≤5mm)anddiffusesmoothwithsmoothlymarginatedandhomogeneouslyechogenicendometrium.Howeverasuspiciousappearancewasdefinedaseitherirregularthickeningoftheendometriumoraninhomogeneousendoluminalmassorpedunculatedendoluminalmassoranyendometrialthicknessabove5mm.Results:Athistologicexamination:of98women,44(45%)hadanatrophicendometrium,11(11%)hadcarcinoma,10(10%)hadhyperplasia,28(29%)hadpolypsand5(5%)wereothers(ovariantumor,leiomyosarcomaandmultipleorgiantleiomyoma)Forcarcinoma,thesensitivityofTVSwas100%,specificitywas41.38%,PPVwas17.4%,andNPVwas100%.Inaddition,thespecificityofTVSforatrophicendometriumwas100%.Conclusion:TVSinpatientswithPMBisanexcellenttoolforthedeterminationofwhetherfurtherinvestigationwithcurettageorsomeformofendometrialbiopsyisnecessaryandsensiblydecreasesthenumberofinvasivemethods.TVSalsoimprovesclinicaldecision-making,andtheclinician’sdiagnosticcertainty.

[学科分类] 基础医学