Correlation between transvaginal ultrasound measured endometrial thickness and histopathological findings in Afro-Caribbean Jamaican women with postmenopausal bleeding

Phillip, H; DaCosta, V; Fletcher, Horace; Kulkarni, Santosh; Reid, Marvin

doi:10.1080/01443610410001722671

Cited by 29 publications

(26 citation statements)

References 10 publications

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“…5,6 In our study, the presence of LN metastasis was associated significantly with the patient's age. Savelli et al reported that ultrasonographies performed in experienced hands have higher degrees of accuracy comparable to MRI in the detection of myometrial invasion in cases with EC.…”

Section: Discussionsupporting

confidence: 50%

The Predictability of Lymph Node Metastasis in Patients with Endometrial Cancer

Yildiz¹,

Özcan²,

Yetimalar³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study was to predict lymphatic involvement in endometrial cancer patients using clinicopathological variables in patients treated with surgical staging. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A retrospective chart review was performed in 147 women with pathologically proven endometrial carcinoma (EC) who were treated between January 2006 and January 2011. Surgically staged 125 patients were included in this study. We choose the patients who underwent surgical staging including washing cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node (PLN) and para-aortic lymph node (PALN) dissection. The depth of tumor invasion, cervical extension and the tumor diameter were intraoperatively assessed via fresh frozen sections of the removed uterus. Demographic data, preoperative and postoperative variables were evaluated for association with any lymph node (LN) metastasis. R Re es su ul lt ts s: : The medical records of 125 patients were eligible for analysis. The presence of LN metastasis was significantly associated with the patient's age (p=0.016) and but not with body mass index (p=0.288). Preoperative findings such as atypical cells in smear (p=0.001), computed tomography (CT) features of malignancy (p=0.014), ultrasonographic findings related with malignancy (p=0.011), presence of myometrial invasion on CT (p=0.011), preoperative serum CA125 level (p<0.001), preoperative serum CA15-3 level (p<0.001), clinical stage (p<0.001), and histologic grade (p=0.001) were significantly associated with LN metastasis. Postoperative findings which were significantly associated with LN metastasis were grade of differentiation, lymphovascular invasion, depth of myometrial invasion, dissemination to omentum or appendix, and positive peritoneal cytology. The mean number of all lymph nodes removed during operation was 38.9±14.194 (range 9-81), PLN number was 32±11.747 (range 9-75) and PALN number was 7±5.123 (range 0-20). Nodal metastasis was shown in 24 patients (19.2%). Isolated PLN metastasis was shown in 9 patients (37%), isolated PALN metastasis in one (4%); both PLN and PALN metastasis was shown in 14 patients (59%). The most frequently affected LN area was the region of the left external iliac artery, with a ratio of 14%.The p value was set at <0.05 for statistical significance. C Co on nc cl lu us si io on n: : Lymphatic involvement in EC should be carefully evaluated using clinicopathologic variables of patients. Demographic characteristics, preoperative and postoperative surgical-pathologic factors determine the lymph node metastasis of the tumor. K Ke ey y W Wo or rd ds s: : Endometrial neoplasms; lymph node excision; lymph nodes Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, cerrahi evreleme uygulanan endometrial kanserli hastalarda klinik ve patolojik değişkenleri kullanarak lenf nodu (LN) tutulumunun öngörülebilmesidir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Ocak 2006 ile O...

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Section: Discussionsupporting

confidence: 50%

The Predictability of Lymph Node Metastasis in Patients with Endometrial Cancer

Yildiz¹,

Özcan²,

Yetimalar³

et al. 2013

Turkiye Klinikleri J Med Sci

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“…Dorum et al ,[19] reported two such cases of endometrial cancer [Figures 4–5] with ET of <4 mm in their series of 100 women with PMB. Philip et al ,[20] reported in their study including 85 Jamaican women that half of the patients with endometrial carcinoma had an ET of 3–4 mm. These articles at the same time, discuss the probable reason for this disparity.…”

Section: Resultsmentioning

confidence: 99%

Hysteroscopy in postmenopausal bleeding

Tandulwadkar

Deshmukh

Lodha

et al. 2009

J Gynec Endosc Surg

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Objectives1) To study the etiology of postmenopausal bleeding (PMB). 2) To study the significance of hysteroscopy in evaluation of the etiopathogenic factors. 3) Correlating the diagnosis after transvaginal sonography (TVS), hysteroscopy and histopathologic diagnosis. 4) Feasibility of conservative management with hysteroscopy in PMB.DesignProspective study from January 2008 to June 2009.SettingDepartment of Obstetrics and Gynecology of Ruby Hall Clinic, Pune.Patients:Sixty postmenopausal women with complaint of bleeding per vaginum.Interventions:Clinical and sonographic evaluation, followed by diagnostic and/or therapeutic hysteroscopy and guided biopsy. Hysteroscopic images were analyzed and compared with histopathologic results.Measurements and Main ResultsOn hysteroscopy, endometrium was classified as suggestive of normal, atrophic, endometrial hyperplasia or endometrial carcinoma. Histopathologic diagnosis is taken as a gold standard to determine the efficacy of hysteroscopy in diagnosing endometrial pathologies. The sensitivity and specificity of hysteroscopy in diagnosing endometrial pathologies was assessed.ConclusionsIn women with PMB, hysteroscopy is the basic tool that allows precise diagnosis of various endouterine pathologies. The average sensitivity of hysteroscopy was 97% in our study and the specificity was 98.66%. Hence, we can conclude that it is highly accurate for evaluating endometrial pathologies. For obvious benign lesions, it also provides treatment in the same sitting, therefore avoiding an extensive, morbid, and expensive procedure like hysterectomy.

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“…While studies have shown that a 5mm or less postmenopausal endometrial thickness is associated with benign histology in white women, this was not confirmed in an Asian population (18–21). A subsequent study of Afro-Caribbean Jamaican women with postmenopausal bleeding found that an endometrial thickness of <5mm did not exclude endometrial cancer (22). In a retrospective cohort study evaluating the predictive value of cycle characteristics for clinical pregnancy in Caucasian women after fresh embryo transfer, Traub et al (23) reported that having a thicker endometrial stripe was a positive predictor of clinical pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Racial differences in fibroid prevalence and ultrasound findings in asymptomatic young women (18–30 years old): a pilot study

Marsh

Ekpo

Cardozo

et al. 2013

Fertility and Sterility

132

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Objectives 1) To determine the prevalence of fibroids in asymptomatic young black and white women (ages 18–30yo); 2) To determine other differences in uterine and adnexal anatomy; 3) To obtain preliminary data for sample size calculations. Design A pilot cross-sectional study. Setting An academic medical center Patients 101 non-parous black and white women, ages 18–30 years old, with no known diagnosis of fibroids or clinically suggestive symptoms. Interventions A transvaginal ultrasound was performed in the follicular phase in all subjects. Main Outcome Measure(s) 1) Presence of fibroids; 2) endometrial thickness; 3) ovarian findings. Results Of the 101 participants (mean age 24.5 ± 3.5), 43% self-identified as black and 57% as white. The prevalence of ultrasound-diagnosed fibroids was 15% overall (26% in black women and 7% in white women). The mean fibroid size was 2.3 ± 2.1 cm. There was a significant difference in endometrial thickness between races, even after adjusting for contraception use and fibroid presence. Conclusions Racial differences in fibroid prevalence exist even before women become symptomatic. Findings of thicker endometrium in black women could have clinical implications and warrants further investigation.

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Correlation between transvaginal ultrasound measured endometrial thickness and histopathological findings in Afro-Caribbean Jamaican women with postmenopausal bleeding

Cited by 29 publications

References 10 publications

The Predictability of Lymph Node Metastasis in Patients with Endometrial Cancer

The Predictability of Lymph Node Metastasis in Patients with Endometrial Cancer

Hysteroscopy in postmenopausal bleeding

Racial differences in fibroid prevalence and ultrasound findings in asymptomatic young women (18–30 years old): a pilot study

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